An Act Concerning Expenditures For The Programs And Services Of The Department Of Public Health.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 19a-202 of the general statutes is repealed and the following is substituted in lieu thereof:
Upon application to the Department of Public Health any municipal health department shall annually receive from the state an amount equal to one dollar and [two] thirteen cents per capita, provided such municipality (1) employs a full-time director of health, except that if a vacancy exists in the office of director of health or the office is filled by an acting director for more than three months, such municipality shall not be eligible for funding unless the Commissioner of Public Health waives this requirement; (2) submits a public health program and budget which is approved by the Commissioner of Public Health; and (3) appropriates not less than one dollar per capita, from the annual tax receipts, for health department services. Such municipal department of health is authorized to use additional funds, which the Department of Public Health may secure from federal agencies or any other source and which it may allot to such municipal department of health. The money so received shall be disbursed upon warrants approved by the chief executive officer of such municipality. The Comptroller shall annually in July and upon a voucher of the Commissioner of Public Health, draw [his] the Comptroller's order on the State Treasurer in favor of such municipal department of health for the amount due in accordance with the provisions of this section and under rules prescribed by [said] the commissioner. Any moneys remaining unexpended at the end of a fiscal year shall be included in the budget of such municipal department of health for the ensuing year. This aid shall be rendered from appropriations made from time to time by the General Assembly to the Department of Public Health for this purpose.
Sec. 2. Subsection (a) of section 19a-202a of the general statutes, as amended by section 3 of public act 99-125, is repealed and the following is substituted in lieu thereof:
(a) Upon application to the Department of Public Health, each part-time health department shall annually receive from the state an amount equal to [fifty-three] fifty-nine cents per capita.
Sec. 3. Section 19a-245 of the general statutes is repealed and the following is substituted in lieu thereof:
Upon application to the [state] Department of Public Health, each health district shall annually receive from the state an amount equal to two dollars and [nine] thirty-two cents per capita for each town, city and borough of such district which has a population of five thousand or less, and one dollar and [seventy-nine] ninety-nine cents per capita for each town, city and borough of such district which has a population of more than five thousand, provided (1) the Commissioner of Public Health approves the public health program and budget of such health district and (2) the towns, cities and boroughs of such district appropriate for the maintenance of the health district not less than one dollar per capita from the annual tax receipts. Such district departments of health are authorized to use additional funds, which the Department of Public Health may secure from federal agencies or any other source and which it may allot to such district departments of health. The district treasurer shall disburse the money so received upon warrants approved by a majority of the board and signed by its chairman and secretary. The Comptroller shall quarterly, in July, October, January and April, upon such application [as aforesaid] and upon the voucher of the Commissioner of Public Health, draw [his] the Comptroller's order on the State Treasurer in favor of such district department of health for the amount due in accordance with the provisions [hereof] of this section and under rules prescribed by [said] the commissioner. Any moneys remaining unexpended at the end of a fiscal year shall be included in the budget of the district for the ensuing year. This aid shall be rendered from appropriations made from time to time by the General Assembly to the Department of Public Health for this purpose.
Sec. 4. Subsection (e) of section 19a-266 of the general statutes is repealed and the following is substituted in lieu thereof:
(e) The Department of Public Health may apply for and receive money from public and private sources and from the federal government for the purposes of a program for breast cancer and cervical cancer early detection and treatment referral. Any payment to the state as a settlement of a court action of which the proceeds may be used for women's health shall be deposited in an account designated for use by the Department of Public Health for breast and cervical cancer treatment services.
Sec. 5. (NEW) To the extent authorized by federal law, the Commissioner of Social Services may seek any federal waivers or amend the state Medicaid plan as necessary in order to secure federal reimbursement for the costs to such plan of providing treatment and other medical services to women diagnosed with breast or cervical cancer under the breast and cervical cancer early detection and treatment referral program established under section 19a-266 of the general statutes, as amended by this act.
Sec. 6. Section 19a-490d of the general statutes is repealed and the following is substituted in lieu thereof:
Each health care facility or institution licensed by the Department of Public Health [,] pursuant to this chapter shall, if advised by the federal Occupational [Health and] Safety and Health Administration, and each health care facility or institution that employs state employees shall use only injectable equipment having self-contained secondary precautionary type sheathing devices or alternate devices designed to prevent accidental needlestick injuries. The provisions of this section shall not apply to any drug or biologic product that is prepackaged with an administration system or used in a prefilled syringe and is approved for commercial distribution or investigational use by the federal Food and Drug Administration, provided a sharp object injury protection disposal system is in place.
Sec. 7. Subsection (a) of section 38a-478e of the general statutes is repealed and the following is substituted in lieu thereof:
(a) Each managed care organization shall, prior to implementing new medical protocols or substantially or materially [altered] altering existing medical protocols, obtain input from physicians actively practicing in Connecticut and practicing in the relevant specialty areas. The managed care organization shall also seek input from physicians who are not employees of or consultants, other than to the extent a person is an employee or consultant solely for the purposes of this subsection, to the managed care organization provided the input is not unreasonably withheld. The managed care organization shall obtain the input in a manner permitting verification by the commissioner and shall document the process by which it obtained the input. For the purpose of this section, "medical protocols" shall include, but not be limited to, drug formularies or lists of covered drugs.
Sec. 8. (NEW) (a) Within available appropriations, the Commissioner of Public Health, in consultation with the Commissioner of Social Services, shall establish a pilot program for the early identification and treatment of pediatric asthma. The Commissioner of Public Health shall make grants-in-aid under the pilot program for projects to be established in two municipalities to identify, screen and refer children with asthma for treatment. Such projects shall work cooperatively with providers of maternal and child health, including, but not limited to, local health departments, community health centers, Healthy Start and Healthy Families, to target children who were born prematurely, premature infants or pregnant women at risk of premature delivery for early identification of asthma. Such projects may utilize private resources through public-private partnerships to establish a public awareness program and innovative outreach initiatives targeting urban areas to encourage early screening of children at risk of asthma.
(b) The Commissioner of Public Health shall evaluate the pilot program established under this section and shall submit a report of the commissioner's findings and recommendations to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and appropriations and the budgets of state agencies, not later than October 1, 2001, in accordance with the provisions of section 11-4a of the general statutes.
Sec. 9. (NEW) There shall be an interagency collaboration, to be known as "Project Safe", between the Department of Mental Health and Addiction Services and the Department of Children and Families, for the evaluation of and service delivery to families identified by the Department of Children and Families as requiring substance abuse and other behavioral health services. Such collaboration shall include, but not be limited to, evaluations, service needs, service delivery, housing, medical coverage, vocation and employment support and other related recovery support services. The Commissioner of Mental Health and Addiction Services and the Commissioner of Children and Families shall enter into a written memorandum of understanding to carry out the interagency collaboration required under this section. The Department of Social Services and the Labor Department may participate in such collaboration as necessary on a case-by-case basis.
Sec. 10. Notwithstanding the provisions of section 20-189 of the general statutes, the education program of an applicant for licensure as a psychologist in this state shall be deemed approved by the Board of Examiners of Psychologists in the case of an applicant who (1) has graduated from an educational institution in another state whose graduates are approved to take the state licensing examination for psychologist in such state, (2) has passed the national psychology licensing examination prior to January 1, 1996, (3) has been licensed to engage in the practice of psychology in such state for a period of at least five years, (4) is a currently practicing doctoral-level psychologist licensed by the professional licensing board of such state and has maintained a practice in psychology in such state for a period of at least five years, and (5) has no history of any professional disciplinary action in any jurisdiction. The provisions of his section shall expire thirty days from the effective date of this section.
Sec. 11. (NEW) (a) There is established an Advisory Commission on Multicultural Health. The mission of the advisory commission shall be the elimination of disparities in health status among the state's cultural and ethnic communities and the overall improvement of the health of state residents. The advisory commission shall consist of:
(1) One member appointed by the president pro tempore of the Senate, who shall be a member of the Black and Puerto Rican Caucus of the General Assembly;
(2) One member appointed by the speaker of the House of Representatives, who shall be a representative of the National Association for the Advancement of Colored People;
(3) One member appointed by the minority leader of the Senate, who shall be a representative of an advocacy group for Native Americans;
(4) One member appointed by the minority leader of the House of Representatives, who shall be a representative of an advocacy group for Asian-Americans;
(5) One member appointed by the Governor, who shall be a representative of an advocacy group for Hispanics;
(6) The chairperson of the Connecticut African-American Affairs Commission;
(7) The chairperson of the Latino and Puerto Rican Affairs Commission;
(8) The chairperson of the Statewide Multicultural Health Steering Committee;
(9) The chairperson of the Permanent Commission on the Status of Women, or the chairperson's designee; and
(10) Eight members of the public, representing diverse multicultural and multiethnic backgrounds, two of whom shall be appointed by the president pro tempore of the Senate, two of whom shall be appointed by the speaker of the House of Representatives, two of whom shall be appointed by the minority leader of the Senate, and two of whom shall be appointed by the minority leader of the House of Representatives.
(b) All initial appointments to the advisory commission shall be made not later than November 1, 2000. The term of each appointed member of the advisory commission shall be coterminous with the term of the appointing authority or until a successor is chosen, whichever is later. During the period commencing on the date that all initial appointments to the advisory commission are made and ending on October 31, 2001, the chairperson of the Statewide Multicultural Health Steering Committee shall serve as chairperson of the advisory commission. On and after November 1, 2001, the Commissioner of Public Health shall appoint a chairperson of the advisory commission.
(c) The advisory commission shall meet quarterly and shall: (1) Advise the Commissioner of Public Health and the director of the Office of Multicultural Health within the Department of Public Health concerning the preparation and implementation of reports and strategic plans and the coordination of issues and policies related to the functions of the Office of Multicultural Health under section 19a-4j of the general statutes; (2) advise the Commissioner of Public Health on the development of a multicultural health promotion plan and monitor the implementation of such plan; and (3) make recommendations to the commissioner and the joint standing committee of the General Assembly having cognizance of matters relating to public health concerning multicultural health issues, policies and programs.
(d) The Office of Multicultural Health within the Department of Public Health shall provide support to the advisory commission within available appropriations.
Sec. 12. (NEW) (a) As used in this section:
(1) "Eligible households" means persons or families who are affected by psychiatric disabilities or chemical dependency, or both, and who are homeless or at risk of homelessness;
(2) "Homeless or at risk of homelessness" means (A) living on the streets or in shelters, (B) coming out of homeless programs or transitional housing and having no permanent housing, (C) living in unsafe or abusive environments, (D) paying more than fifty per cent of income for rent, (E) living in overcrowded conditions, or (F) being in need of supportive services in order to maintain permanent housing; and
(3) "Commissioner" means the Commissioner of Mental Health and Addiction Services.
(b) The commissioner shall implement and administer a program to provide grants-in-aid to nonprofit corporations for the purpose of providing support services to eligible households. Such services shall be designed to enable residents of eligible households to (1) obtain and keep permanent housing, (2) increase their job skills and income, and (3) achieve greater self-determination.
(c) The commissioner shall leverage funding from private and federal funding sources in providing grants-in-aid for support services under this section.
(d) The commissioner may adopt regulations, in accordance with chapter 54 of the general statutes, to carry out the provisions of this section.
Sec. 13. (NEW) (a) The Commissioner of Mental Health and Addiction Services shall, within available appropriations, establish a pilot peer engagement specialist program, in one mental health region designated pursuant to section 17a-478 of the general statutes, to provide intensive community support and case management services for persons who require individualized outreach services due to their persistent rejection of traditional mental health services and potential for violence. An individual shall be offered a peer engagement specialist under the program when the commissioner determines, based on objective documentation, that such individual (1) has inflicted or threatened to inflict serious physical injury upon another person or persons on one or more occasions within the last five years, (2) has demonstrated a persistent rejection of traditional mental health services, and (3) needs the services offered by an engagement specialist and would benefit from such services.
(b) Not later than September 1, 2000, the commissioner may hire or contract with persons who are in recovery from psychiatric disabilities to act as peer engagement specialists under the program established under this section. Such peer engagement specialists, when so hired or contracted with, shall be accountable to the Department of Mental Health and Addiction Services. The peer engagement specialists shall participate in the assessment of individuals being considered for participation in the program established under this section. The responsibilities of the peer engagement specialists shall include, but are not be limited to: (1) Assisting in the creation of the individual's recovery plan; (2) participating in or initiating conferences designed to establish individualized service strategies; (3) providing consultation to the primary care agencies; (4) participating in all treatment meetings concerning the individual; (5) providing outreach, support and follow-up services to program participants; (6) ensuring that a partnership exists among the individual participant, the peer engagement specialist and the assigned care manager; (7) serving as peer and role model for individual participants; (8) teaching life skills and interpersonal skills that will ultimately help individual participants to build their own circles of support; (9) assisting in the development of natural support systems within the community; and (10) assisting assigned care managers with the ongoing process of engagement and linkage.
(c) The peer engagement specialists shall be given access to initial training for their responsibilities, and periodic continuing training thereafter. Such training shall include, but not be limited to, training on advance directives that allow program participants to specify the types of mental health intervention they would accept in the event of a crisis. The peer engagement specialists shall inform all participating individuals concerning such advance directives and shall encourage the use of such advance directives by such individuals. The commissioner shall ensure that technical assistance by an independent entity that is not a provider of mental health services is made available to assist peer engagement specialists with such advance directives. The commissioner shall issue a certificate to each peer engagement specialist who is hired by the department and satisfactorily completes such training.
(d) Not later than July 1, 2000, the Commissioner of Mental Health and Addiction Services shall appoint an advisory committee to advise the commissioner on the design and implementation of the program established under this section. The committee shall be composed of twelve members, six of whom shall be present or former consumers of mental health services, advocates for such consumers or family members of such consumers, and shall be knowledgeable concerning the concept of engaging persons who are resistant to receiving mental health services and knowledgeable concerning principles of recovery, and six of whom shall be representatives of providers of mental health services, the Department of Mental Health and Addiction Services or professional organizations associated with the mental health field.
(e) Not later than January 15, 2002, the Commissioner of Mental Health and Addiction Services shall submit a report containing an evaluation of the operation and effectiveness of the program established under this section to the joint standing committee of the General Assembly having cognizance of matters relating to public health, in accordance with the provisions of section 11-4a of the general statutes. The report shall include, but not be limited to, (1) the findings and recommendations of the commissioner with respect to the program, which shall include the relevant clinical benchmarks for evaluating the participants and the program itself, and (2) the recommendations of the peer engagement specialists and the advisory committee with respect to the need for services.
Sec. 14. Section 26 of public act 99-2 of the June special session is repealed and the following is substituted in lieu thereof:
(a) There is created a Tobacco Settlement Fund which shall be a separate nonlapsing fund. Any funds received by the state from the Master Settlement Agreement executed November 23, 1998, shall be deposited into the fund.
(b) (1) The Treasurer is authorized to invest all or any part of the Tobacco Settlement Fund, [and] all or any part of the Tobacco and Health Trust Fund created in section 27 of [this act] public act 99-2 of the June special session, as amended by this act, and all or any part of the Biomedical Research Trust Fund created in section 17 of this act. The interest derived from any such investment shall be credited to the resources of the fund from which the investment was made.
(2) Notwithstanding sections 3-13 to 3-13h, inclusive, as amended, the Treasurer shall invest the amounts on deposit in the Tobacco Settlement Fund, the Tobacco and Health Trust Fund and the Biomedical Research Trust Fund in a manner reasonable and appropriate to achieve the objectives of such funds, exercising the discretion and care of a prudent person in similar circumstances with similar objectives. The Treasurer shall give due consideration to rate of return, risk, term or maturity, diversification of the total portfolio within such funds, liquidity, the projected disbursements and expenditures, and the expected payments, deposits, contributions and gifts to be received. The Treasurer shall not be required to invest such funds directly in obligations of the state or any political subdivision of the state or in any investment or other fund administered by the Treasurer. The assets of such funds shall be continuously invested and reinvested in a manner consistent with the objectives of such funds until disbursed in accordance with this section, section 27 of public act 99-2 of the June special session, as amended by this act, or section 17 of this act.
(c) (1) For the fiscal years ending June 30, 2000, and June 30, 2001, annual disbursements from the Tobacco Settlement Fund shall be made as follows: [(1) First to] (A) To the General Fund in the amount identified as "Transfer from Tobacco Settlement Fund" in the General Fund revenue schedule adopted by the General Assembly; and [(2) second] (B) to the Tobacco and Health Trust Fund in an amount equal to twenty million dollars.
(2) For the fiscal year ending June 30, 2002, and each fiscal year thereafter, disbursements from the Tobacco Settlement Fund shall be made as follows: (A) To the Tobacco and Health Trust Fund in an amount equal to twelve million dollars; (B) to the Biomedical Research Trust Fund in an amount equal to four million dollars; (C) to the General Fund in the amount identified as "Transfer from Tobacco Settlement Fund" in the General Fund revenue schedule adopted by the General Assembly; and (D) any remainder to the Tobacco and Health Trust Fund.
[(d) Notwithstanding the provisions of subdivision (2) of subsection (c) of this section, for]
(d) For the fiscal year ending June 30, 2000, five million dollars shall be disbursed from the Tobacco Settlement Fund to a tobacco grant account to be established in the Office of Policy and Management. Such funds shall not lapse on June 30, 2000, and shall continue to be available for expenditure during the fiscal year ending June 30, 2001.
(e) [Grants] Tobacco grants shall be made from the account established pursuant to subsection (d) of this section by the Secretary of the Office of Policy and Management in consultation with the speaker of the House of Representatives, the president pro tempore of the Senate, the majority leader of the House of Representatives, the majority leader of the Senate, the minority leader of the House of Representatives, the minority leader of the Senate, and the cochairpersons and ranking members of the joint standing committees of the General Assembly having cognizance of matters relating to public health and appropriations and the budgets of state agencies, or their designees. Such grants shall be used to reduce tobacco abuse through prevention, education, cessation, treatment, enforcement and health needs programs.
Sec. 15. Section 27 of public act 99-2 of the June special session is repealed and the following is substituted in lieu thereof:
(a) There is created a Tobacco and Health Trust Fund which shall be a separate nonlapsing fund. The purpose of the trust fund shall be to create a continuing significant source of funds to (1) support and encourage development of programs to reduce tobacco abuse through prevention, education and cessation programs, (2) support and encourage development of programs to reduce substance abuse, and (3) develop and implement programs to meet the unmet physical and mental health needs in the state.
(b) The trust fund may accept transfers from the Tobacco Settlement Fund and may apply for and accept gifts, grants or donations from public or private sources to enable the trust fund to carry out its objectives.
(c) The trust fund shall be administered by a board of trustees which shall consist of seventeen trustees. The appointment of the initial trustees shall be as follows: (1) The Governor shall appoint four trustees, one of whom shall serve for a term of one year from July 1, 2000, two of whom shall serve for a term of two years from July 1, 2000, and one of whom shall serve for a term of three years from July 1, 2000; (2) the speaker of the House of Representatives and the president pro tempore of the Senate each shall appoint two trustees, one of whom shall serve for a term of two years from July 1, 2000, and one of whom shall serve for a term of three years from July 1, 2000; (3) the majority leader of the House of Representatives and the majority leader of the Senate each shall appoint two trustees, one of whom shall serve for a term of one year from July 1, 2000, and one of whom shall serve for a term of three years from July 1, 2000; (4) the minority leader of the House of Representatives and the minority leader of the Senate each shall appoint two trustees, one of whom shall serve for a term of one year from July 1, 2000, and one of whom shall serve for a term of two years from July 1, 2000; and (5) the Secretary of the Office of Policy and Management, or the secretary's designee, as an ex-officio voting member. Following the expiration of such initial terms, subsequent trustees shall serve for a term of three years. The trustees shall serve without compensation except for reimbursement for necessary expenses incurred in performing their duties. The board of trustees shall establish rules of procedure for the conduct of its business which shall include, but not be limited to, criteria, processes and procedures to be used in selecting programs to receive money from the trust fund. The trust fund shall be within the Office of Policy and Management for administrative purposes only.
(d) (1) During the period commencing July 1, 2000, and ending June 30, 2005, the board of trustees, by majority vote, may recommend authorization of disbursement from the trust fund for the purposes described in subsection (a) of this section and section 16 of this act, provided the board may not recommend authorization of disbursement of more than fifty per cent of net earnings from the principal of the trust fund for such purposes. For the fiscal year commencing July 1, 2005, and each fiscal year thereafter, the board may recommend authorization of the net earnings from the principal of the trust fund for such purposes. The board's recommendations shall give (A) priority to programs that address tobacco and substance abuse and serve minors, pregnant women and parents of young children, and (B) consideration to the availability of private matching funds. Recommended disbursements from the trust fund shall be in addition to any resources that would otherwise be appropriated by the state for such purposes and programs.
(2) The board of trustees shall submit such recommendations for the authorization of disbursement from the trust fund to the joint standing committees of the General Assembly having cognizance of matters relating to public health and appropriations and the budgets of state agencies. Not later than thirty days after receipt of such recommendations, said committees shall advise the board of their approval, modifications, if any, or rejection of the board's recommendations. If said joint standing committees do not concur, the speaker of the House of Representatives, the president pro tempore of the Senate, the majority leader of the House of Representatives, the majority leader of the Senate, the minority leader of the House of Representatives and the minority leader of the Senate each shall appoint one member from each of said joint standing committees to serve as a committee on conference. The committee on conference shall submit its report to both committees, which shall vote to accept or reject the report. The report of the committee on conference may not be amended. If a joint standing committee rejects the report of the committee on conference, the board's recommendations shall be deemed approved. If the joint standing committees accept the report of the committee on conference, the joint standing committee having cognizance of matters relating to appropriations and the budgets of state agencies shall advise the board of said joint standing committees' approval or modifications, if any, of the board's recommended disbursement. If said joint standing committees do not act within thirty days after receipt of the board's recommendations for the authorization of disbursement, such recommendations shall be deemed approved. Disbursement from the trust fund shall be in accordance with the board's recommendations as approved or modified by said joint standing committees.
(3) After such recommendations for the authorization of disbursement have been approved or modified pursuant to subdivision (2) of this subsection, any modification in the amount of an authorized disbursement in excess of fifty thousand dollars or ten per cent of the authorized amount, whichever is less, shall be submitted to said joint standing committees and approved, modified or rejected in accordance with the procedure set forth in subdivision (2) of this subsection. Notification of all disbursements from the trust fund made pursuant to this section shall be sent to the joint standing committees of the General Assembly having cognizance of matters relating to public health and appropriations and the budgets of state agencies, through the Office of Fiscal Analysis.
(4) The board of trustees shall, not later than February first of each year, submit a report to the General Assembly, in accordance with the provisions of section 11-4a of the general statutes, that includes all disbursements and other expenditures from the trust fund and an evaluation of the performance and impact of each program receiving funds from the trust fund. Such report shall also include the criteria and application process used to select programs to receive such funds.
Sec. 16. (NEW) The Commissioner of Public Health and the Commissioner of Mental Health and Addiction Services shall, within available appropriations, develop a Tobacco Abuse Reduction and Health Plan and shall submit such plan to the joint standing committees of the General Assembly having cognizance of matters relating to public health and appropriations and the budgets of state agencies, not later than April 1, 2001. The plan shall consider and recommend actions to (1) reduce tobacco and substance abuse, and (2) address the unmet physical and mental health needs of the state, taking into account the most recent version of the state health plan prepared by the Department of Public Health pursuant to section 19a-7 of the general statutes.
Sec. 17. (NEW) There is created a Biomedical Research Trust Fund which shall be a separate nonlapsing fund. The trust fund may accept transfers from the Tobacco Settlement Fund and may apply for and accept gifts, grants or donations from public or private sources to enable the account to carry out its objectives. On and after July 1, 2001, the Commissioner of Public Health may make grants-in-aid from the trust fund to eligible institutions for the purpose of funding biomedical research in the fields of heart disease, cancer and other tobacco-related diseases. For the fiscal year ending June 30, 2002, the total amount of such grants-in-aid made during the fiscal year shall not exceed two million dollars. For the fiscal year ending June 30, 2003, and each fiscal year thereafter, the total amount of such grants-in-aid made during the fiscal year shall not exceed fifty per cent of the total amount held in the trust fund as of the date such grants-in-aid are approved. Not later than April 1, 2001, the Commissioner of Public Health shall develop an application for grants-in-aid under this section and may receive applications from eligible institutions for such grants-in-aid on and after said date. For purposes of this section, "eligible institution" means (1) a nonprofit, tax-exempt academic institution of higher education, or (2) a hospital that conducts biomedical research.
Sec. 18. (NEW) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2001, shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist which may include all means medically necessary to make a diagnosis and develop a treatment plan including the use of necessary medications and procedures. As used in this section, "pain" means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and "pain management specialist" means a physician who is credentialed by the American Academy of Pain Management or who is a board certified anesthesiologist, neurologist, oncologist or radiation oncologist with additional training in pain management.
Sec. 19. (NEW) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, renewed, amended or continued in this state on or after January 1, 2001, shall provide access to a pain management specialist and coverage for pain treatment ordered by such specialist which may include all means medically necessary to make a diagnosis and develop a treatment plan including the use of necessary medications and procedures. As used in this section, "pain" means a sensation in which a person experiences severe discomfort, distress or suffering due to provocation of sensory nerves, and "pain management specialist" means a physician who is credentialed by the American Academy of Pain Management or who is a board certified anesthesiologist, neurologist, oncologist or radiation oncologist with additional training in pain management.
Sec. 20. (NEW) The Department of Public Health shall: (1) Develop a single, uniform method for collecting and analyzing standardized data concerning the linkage between nurse staffing levels and the quality of acute care, long-term care and home care, including patient outcomes; (2) conduct an ongoing study of the relationship between nurse staffing patterns in hospitals and the quality of health care, including patient outcomes; (3) obtain relevant licensure and demographic data that may be available from other state agencies and make the data collected under this subsection available to the public in a standardized format; and (4) collaborate with hospitals and the nursing profession with respect to the collection of standardized data concerning patient care outcomes at such hospitals and make such data available to the public in a report card format.
Sec. 21. The Commissioner of Public Health shall conduct a study concerning the shortage of nurses in this state. Such study shall include, but not be limited to: (1) An examination of the causes underlying the current shortage of nurses in this state and recommendations for the alleviation of such shortage; (2) recommendations for implementing methods of collecting uniform data concerning nurse-to-patient ratios in hospitals, nursing homes and home health agencies, including the feasibility of obtaining such data from other state or federal agencies; and (3) recommendations for supplementing nursing care in this state in response to such shortage, including recommendations concerning the feasibility of developing criteria for the certification, training and supervision of medication technicians in long-term care facilities. Not later than December 31, 2000, the commissioner shall submit a report of the commissioner's findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health, in accordance with the provisions of section 11-4a of the general statutes.
Sec. 22. For the fiscal year ending June 30, 2001, the sum of thirty thousand dollars shall be transferred from the Tobacco and Health Trust Fund to the Department of Public Health, Other Expenses, for the purpose of implementing the provisions of public act 00-57.
Sec. 23. Notwithstanding the provisions of subsection (a) of section 20-195dd of the general statutes, as amended, an applicant for a license as a professional counselor may, in lieu of the requirements for completion of graduate semester hours at a regionally accredited institution of higher education or the earning of a degree from a regionally accredited institution of higher education, or both, as set forth in subdivision (1) of subsection (a) of section 20-195dd of the general statutes, as amended, submit evidence satisfactory to the commissioner of: (1) Having satisfied the graduate semester hour requirements or degree requirements, or both, as set forth in said subdivision, at an institution of higher education other than a regionally accredited institution of higher education; and (2) continuous employment as a supervisor of psychologists, social workers, counselors or similar professionals for a minimum of fifteen years within a five-year period immediately preceding application. The commissioner shall accept the requirements of this subsection in lieu of the applicable requirements of subsection (a) of section 20-195dd of the general statutes, as amended, provided the provisions of this subsection shall not apply after the date that is thirty days after the effective date of this section.
Sec. 24. The sum of thirty-three thousand dollars appropriated to the Department of Public Health in section 1 of special act 00-13, for the fiscal year ending June 30, 2001, for Other Expenses, shall be used by the Commissioner of Public Health as matching funds for the purpose of applying for a traumatic brain injury planning grant under the federal Health Resources and Services Administration TBI Demonstration Grant Program. Such planning grant shall be used to conduct a state-wide needs and resource assessment to develop a state-wide action plan for a comprehensive, community-based system of traumatic brain injury care.
Sec. 25. The sum of fifty thousand dollars appropriated to the Department of Public Health in section 1 of special act 00-13, for the fiscal year ending June 30, 2001, for Other Expenses, shall be used by the Commissioner of Public Health to enter into a contract with Child and Family Services of Southeastern Connecticut for the purpose of establishing two school-based health centers.
Sec. 26. (NEW) (a) For purposes of this section:
(1) "Commissioner" means the Commissioner of Public Health;
(2) "Eligible families" means any household which (A) is eligible for the federal Medicaid program, (B) includes a child who is six years of age or younger as of the effective date of this section, and (C) is residing in a building built prior to 1978; and
(3) "The program" or "this program" means the program established by this section.
(b) The Commissioner of Public Health may establish a program to promote environmentally safe housing for children and families through education, medical screening and appropriate and cost-effective repairs. Such program may (A) identify eligible families and, through voluntary home visits, provide education about the problems caused by exposure to lead and how to avoid or lessen the effects of such exposure, (B) provide blood lead screening for children who are six years of age or younger, (C) identify measures to be taken to lessen the effects from the presence of lead, including window repair or replacement, (D) apply to federal programs and to other funding sources which will pay for some of the costs of this program, and (E) continue to evaluate the program's progress in order to plan for a phase-out in three to five years. The commissioner may contract with a nonprofit entity to operate the program.
(c) Eligible costs by a nonprofit entity operating this program shall include costs and expenses incurred in providing lead-safety education, interim measures and window repair or replacement or other remediation for dwelling units, administrative and management expenses, planning and start-up costs, and any other costs and expenses found by the commissioner to be necessary and reasonable and in accordance with existing state regulations.
Sec. 27. (NEW) (a) As used in this section, "registered nurse's aide" shall have the same meaning as provided in section 20-102aa of the general statutes.
(b) The Commissioner of Public Health may adopt regulations, in accordance with chapter 54 of the general statutes, to authorize the administration of medications in nursing homes by registered nurse's aides. Any such regulations shall include, but not be limited to, minimum education and training requirements, provisions concerning supervision, restrictions on medications to be administered, and provisions for disciplinary procedures. The commissioner may implement procedures for the administration of medications in nursing homes by registered nurse's aides while in the process of adopting such procedures in regulation, provided the commissioner prints notice of intention to adopt the regulations in the Connecticut Law Journal within twenty days after implementing the procedures. Such procedures shall be valid until the time the final regulations are effective.
Sec. 28. This act shall take effect from its passage, except that sections 1 to 9, inclusive, 11 to 13, inclusive, and sections 22, 24, 25, 26 and 27 shall take effect July 1, 2000, section 20 shall take effect October 1, 2000, and sections 18 and 19 shall take effect January 1, 2001.
Approved June 1, 2000