PA 07-252—sHB 7163

Public Health Committee

Judiciary Committee

General Law Committee

AN ACT CONCERNING REVISIONS TO STATUTES RELATING TO THE DEPARTMENTS OF PUBLIC HEALTH AND SOCIAL SERVICES AND TOWN CLERKS

SUMMARY: This act expands the scope of practice of podiatric medicine to allow podiatrists to engage independently in standard and advanced ankle surgery procedures if they meet certain requirements and qualifications. Under the act, licensed podiatrists with additional qualifications beyond board qualification or certification may be permitted to perform surgical treatment of the ankle. Surgical treatment of the ankle does not include the performance of total ankle replacements or treatment of tibial pilon fractures.

Under the act, a podiatrist cannot engage in independent ankle surgery procedures without receiving a permit from the Department of Public Health (DPH). DPH must develop a process for issuing such permits.

The act requires the DPH commissioner to appoint a four-member advisory committee consisting of podiatrists and orthopedists to assist in evaluating permit applicants. The commissioner must also adopt regulations for evaluating an applicant's training and experience in various ankle procedures.

The act also makes numerous substantive and technical changes to Department of Public Health (DPH) and related statutes concerning health care professionals; health care facilities, programs and activities; and health care decision-making. It also addresses recording of certain instruments by town clerks.

EFFECTIVE DATE: Various, see below.

34 — PODIATRY: STANDARD AND ADVANCED ANKLE SURGERY PROCEDURES

Types of Surgery

Under the act, “standard ankle surgery procedures” include soft tissue and osseous (bone) procedures.

“Advanced ankle surgery procedures” include ankle fracture fixation, ankle fusion, ankle arthroscopy, insertion or removal of external fixation pins into or from the tibial diaphysis (shaft of a long bone) at or below the level of the myotendinous junction (junction formed by the skeletal muscles where they adhere to tendons) of the triceps surae, and insertion and removal of retrograde tibiotalocalcaneal intramedullary rods and locking screws up to the level of the myotendinous junction of the triceps surae. It does not include the surgical treatment of complications within the tibial diaphysis related to the use of such external fixation pins.

“Triceps surae” refers to the group of lower leg muscles called the gastrocnemius and the soleus. The gastrocnemius is the two-headed, heart-shaped muscle in the back of the lower leg. The soleus is the broader, flat muscle just beneath the gastrocs. Both of these muscles attach to the heal bone via the Achilles tendon. The triceps surae makes up the superficial, posterior lower leg compartment.

Independent Ankle Surgery

Requirements for Standard Ankle Surgery. The act permits licensed podiatrists with the following qualifications to independently engage in standard ankle procedures:

1. those who graduated on or after June 1, 2006 from a three-year residency program in podiatric medicine and surgery accredited at the time of graduation by the Council on Podiatric Medical Education, or its successor, and who hold and maintain current board certification in reconstructive rearfoot ankle surgery by the American Board of Podiatric Surgery, or its successor;

2. those who graduated on or after June 1, 2006 from a three-year residency program in podiatric medicine and surgery accredited by the council or its successor, at the time of graduation, who are qualified, but not certified, in reconstructive rearfoot ankle surgery by the board or its successor, and who provide documentation satisfactory to DPH of their training and experience in standard or advanced midfoot, rearfoot, and ankle procedures, except that such applicants cannot perform osteotomies of the tibia and fibula until they hold and maintain current board certification as described above; or

3. those who graduated before June 1, 2006 from a residency program of at least two years in podiatric medicine and surgery that was accredited by the council at the time of graduation, hold and maintain current board certification, and provide satisfactory documentation to DPH of their training and experience in standard or advanced midfoot, rearfoot, and ankle procedures.

Requirements for Advanced Ankle Surgery. Under the act, licensed podiatrists with the following qualifications can engage independently in advanced ankle surgery procedures:

1. those who graduated on or after June 1, 2006 from a three-year residency program in podiatric medicine and surgery accredited at the time of graduation by the Council on Podiatric Medical Education or its successor, hold and maintain current board certification in reconstructive rearfoot ankle surgery by the American Board of Podiatric Surgery or its successor, and provide satisfactory documentation to DPH of their training and experience in advanced midfoot, rearfoot, and ankle procedures; or

2. those who graduated before June 1, 2006 from a residency program of at least two years in podiatric medicine and surgery accredited by the council at the time of graduation, hold and maintain current board certification, and provide satisfactory documentation to DPH of their training and experience in advanced midfoot, rearfoot, and ankle procedures.

Ankle Surgery Under The Direct Supervision of a Physician or Surgeon

The act specifies conditions under which a licensed podiatrist may surgically treat the ankle, including using standard and advanced podiatric ankle surgery procedures, without a permit until the podiatrist meets the requirements for a permit for independent ankle surgery. The podiatrist must perform these procedures under the direct supervision of a licensed physician or surgeon who has hospital privileges in the procedure or of a licensed podiatrist who has a permit for independent ankle surgery. The podiatrist must also:

1. have graduated from a minimum two-year residency program in podiatric medicine and surgery accredited at the time of graduation by the Council on Podiatric Medical Education, or its successor; and

2. hold and maintain current board certification in reconstructive rearfoot ankle surgery by the American Board of Podiatric Surgery, or its successor; be board qualified in such surgery by the board, or its successor; or be currently board certified in foot and ankle surgery by the board, or its successor.

DPH Permit Process

The act requires DPH to establish a process to issue permits to qualified licensed podiatrists to independently perform standard or advanced ankle surgery procedures as described above. No licensed podiatrist may independently engage in the surgical treatment of the ankle or the anatomical structures of the ankle, administer or prescribe drugs incidental to such treatment, or surgically treat manifestations of systemic diseases as they appear on the ankle, until the podiatrist has obtained a DPH permit.

DPH cannot issue a permit unless the applicant meets all of the requirements for independent ankle surgery as described above and pays a $100 fee.

The act specifies that “surgical treatment of the ankle” does not include performing total ankle replacements or treating tibial pilon fractures.

Advisory Committee

The act requires the DPH commissioner to appoint a four-member advisory committee to assist and advise him in evaluating each applicant's training and experience in midfoot, rearfoot, and ankle procedures required for permit eligibility. Two committee members must be podiatrists recommended by the Connecticut Podiatric Medical Association and two must be orthopedists recommended by the Connecticut Orthopedic Society.

Regulations

The act requires DPH to adopt regulations on the permit issuance process, including evaluation of an applicant's training and experience in the procedures required for a permit. The regulations must include the number and types of procedures required for an applicant to demonstrate training or experience in standard and advanced ankle procedures. DPH must seek the advisory committee's advice and assistance and consider nationally recognized standards for accredited residency programs in podiatric medicine and surgery in developing the regulations.

The act specifies that DPH can issue permits to qualified licensed podiatrists to independently perform standard or advanced ankle surgery procedures before the effective date of the regulations DPH must adopt.

Podiatrist Privileges

The act specifies that DPH's permit issuance to a licensed podiatrist to independently engage in ankle surgery does not obligate a hospital or outpatient surgical facility to grant privileges to that podiatrist.

EFFECTIVE DATE: October 1, 2007

35 — DISCIPLINARY ACTION AGAINST PODIATRISTS

The act adds engaging in surgical treatment of the ankle without the required permit to the grounds on which the Connecticut Board of Examiners in Podiatry can take disciplinary action against a podiatrist.

EFFECTIVE DATE: October 1, 2007

5 — CIVIL PENALTIES AGAINST HEALTH CARE PROFESSIONALS

The act increases, from $10,000 to $25,000, the civil penalty DPH and various health professional regulatory boards can assess against a health care professional. By law, DPH and various health professional boards and commissions can, after finding good cause, take various disciplinary actions against licensed health professionals. These actions include license suspension or revocation, censure, letter of reprimand, probation, or assessment of a civil penalty.

EFFECTIVE DATE: October 1, 2007

6 — LABORATORY FEES

The act allows, rather than requires, the DPH commissioner to set laboratory fees and to do so without basing them on nationally recognized standards and performance measures for analytic work effort for such services as previously required. By law, DPH can establish state laboratories to test for preventable disease, as well as to perform sanitation, environmental, and occupational testing.

Laboratory services are provided without charge for local health directors and local law enforcement officials. The law also allows for partial, as well as full, fee waivers for others if the commissioner determines the public health requires it. The act clarifies that the commissioner can waive the fees if he establishes a fee schedule.

EFFECTIVE DATE: October 1, 2007

7-9 — HIV AND AIDS SERVICES

The act revises funding provisions for HIV and AIDS services. It expands the types of organizations that can receive funds to provide such services and expands service recipients to include people with HIV and those at risk of contracting HIV or AIDS.

By law, DPH must establish a grant program to fund private agencies that provide services to persons suffering from AIDS and their families. Under the act, qualifying individuals and organizations, including local health departments, that serve people infected with, at risk of, or affected by HIV or AIDS are eligible for grants.

Under existing law, agencies receiving DPH funding to provide AIDS tests must give priority to persons in high-risk categories and must establish a fee schedule based on ability to pay. The act eliminates the fee schedule requirement and specifies that the testing is for HIV.

The act also specifies that DPH's existing public information program must address HIV as well as AIDS.

The act broadens the eligibility criteria for grant-in-aid applicants for programs to study or treat AIDS. Under the act, such grants are available to qualifying individuals or organizations instead of just any hospital, municipality, public independent college or university, or individual. It also provides that the grants are for studying or treating HIV, AIDS, or both.

The act eliminates a requirement that DPH adopt regulations concerning administration of the grant program.

EFFECTIVE DATE: October 1, 2007

11, 80 — CREMATORIES AND CREMATION

The act requires crematories to keep on their premises records, copies of cremation permits, cremation authorization documentation, and documentation of receipt of cremated remains for at least three years after final disposition of the cremated remains.

EFFECTIVE DATE: October 1, 2007

The act specifies that, if the body of a deceased person is brought into Connecticut from another state for cremation with a permit for final disposition indicating cremation issued by the legal authority of the other state, that permit is sufficient authority for cremation and no additional permit is needed. (This provision amends PA 07-104. )

EFFECTIVE DATE: July 1, 2007

32, 85 — FUNERALS AND FUNERAL SERVICE BUSINESSES

The act requires a person, firm, partnership, or corporation involved in the funeral service business to keep at the funeral business address of record (1) copies of all death certificates, burial permits, cremation authorizations, receipts for cremated remains, and written agreements used in making arrangements for final disposition of dead bodies, including copies of the final bill and other written evidence of agreement or obligation given to consumers, for at least three years after final disposition and (2) copies of price lists, for at least three years from the last date they were distributed to consumers.

EFFECTIVE DATE: October 1, 2007

PA 07-104 defines “disinfecting solution,” for purposes of preparing and transporting dead bodies, as an aqueous solution or spray containing at least 5% phenol by weight. This act amends this to include “or an equivalent in germicidal action.

EFFECTIVE DATE: Upon passage

12 & 13 — ASSISTED LIVING SERVICES AGENCY

The act adds assisted living services agencies to the statutory list of health care institutions and makes a technical change to the definition of such agencies.

EFFECTIVE DATE: October 1, 2007

1, 2, & 19-21 — APPOINTMENT OF HEALTH CARE REPRESENTATIVE, POWER OF ATTORNEY FOR HEALTH CARE DECISIONS, SHOCK THERAPY

The act specifies that a short-form power of attorney can no longer be used for health care decision purposes.

It specifies that an appointment of a (1) health care agent or (2) power of attorney for health care decisions, properly executed before October 1, 2006 under the law in effect at that time has the same legal force and effect as if it had been executed according to the law after October 1, 2006. PA 06-195 amended and updated Connecticut law on health care decision-making by, among other things, (1) combining the authority of the health care agent and attorney-in-fact for health care decisions into a unified proxy known as the “health care representative” and (2) authorizing the health care representative to make any and all health care decisions for a person incapable of expressing those wishes.

For purposes of the appointment of a health care representative and health care decision-making, the act specifies that “shock therapy” is as defined under the law on patients' rights for persons with psychiatric disabilities (CGS 17a-540).

EFFECTIVE DATE: October 1, 2007

23 & 24 — ALCOHOL AND DRUG COUNSELORS

Existing law provides that the alcohol and drug abuse counselor licensure and certification statutes do not apply to the activities of various licensed professionals acting within the scope of their profession, doing work consistent with their training, and not holding themselves out as alcohol and drug counselors.

The act amends this exception by (1) removing chiropractors, acupuncturists, physical therapists, and occupational therapists from the exempt list; (2) adding professional counselors; and (3) specifying that “nurses” mean advanced practice registered nurses and registered nurses. It also specifies that the person must be working consistent with his or her license, rather than with his or her “training.

EFFECTIVE DATE: Upon passage

25 — PODIATRY

The act eliminates a requirement that a podiatrist provide DPH with satisfactory evidence of a high school diploma or its equivalent in order to obtain a license.

EFFECTIVE DATE: October 1, 2007

26 & 27 — PHYSICAL THERAPISTS AND PHYSICAL THERAPIST ASSISTANTS

The law allows DPH to license without examination physical therapists and physical therapist assistants licensed or registered in another state or nation with similar or higher requirements than Connecticut's. The act instead specifies that DPH must deem the other state's or nation's requirements to be equivalent to or higher than Connecticut's.

EFFECTIVE DATE: October 1, 2007

30, 79 — OPTOMETRISTS

The act deletes (1) requirements that an optometrist applying for a license present satisfactory evidence to DPH of graduating from an approved high school or its equivalent and (2) related provisions and examination fees concerning license applicants who have not graduated from an approved high school. It deletes a requirement that optometry schools have a minimum course of study of 1,000 attendance hours in order to be approved by the state optometry board. It also eliminates a provision that specifies that a school cannot be disapproved solely because it is located outside of the United States.

The act requires that optometric license applicants successfully complete an examination prescribed, rather than conducted, by DPH with the consent of, instead of under the supervision of, the Board of Examiners for Optometrists. It also specifies that the examination cover the treatment and management of ocular disease.

The act makes both technical and substantive changes to requirements for licensure by endorsement. (Endorsement basically means that a licensee from another state may be eligible for licensure, without examination, in this state provided that the applicant has credentials and qualifications substantially equivalent to Connecticut's licensure requirements. ) The act eliminates a requirement that the other state give a similar privilege to Connecticut licensees seeking licensure in that state in order for Connecticut to license someone from that state by endorsement. It allows DPH to license by endorsement an optometrist who holds a Council on Endorsed Licensure Mobility for Optometrists certificate issued by the Association of Regulatory Boards of Optometry, or its successor.

The act eliminates (1) a requirement that DPH annually inform the optometry board of the number of applications it receives for licensure without examination and (2) a provision that specifies that an otherwise qualified person cannot be denied the right to apply for or receive an optometrist's license solely because he or she is not a United States citizen. It also eliminates a $50 examination fee.

The act restores “treatment of iritis” to the definition of “noninvasive procedures” for optometrists, which was inadvertently dropped in PA 07-92.

EFFECTIVE DATE: October 1, 2007

31 — RESPIRATORY CARE PRACTITIONERS

Existing law requires a respiratory care practitioner applying for license renewal to either (1) earn a minimum of six contact hours of continuing education within the preceding registration period or (2) maintain credentialing as a respiratory therapist from the National Board for Respiratory Care. The act eliminates the latter option. A registration period is the one-year period for which a renewed license is current and valid.

EFFECTIVE DATE: July 1, 2007

33 — SANITARIANS

The act expands the grounds on which DPH may refuse to issue or renew, or suspend, a license or take other disciplinary action against a sanitarian as follows: (1) the sanitarian has been found guilty or convicted of an act which is a felony under Connecticut or federal law, or under the laws of another jurisdiction, which, if committed in Connecticut, would have been a felony or (2) the sanitarian has been subject to disciplinary action similar to that of Connecticut's by an authorized professional disciplinary agency in any state, the District of Columbia, a U. S. territory or possession, or a foreign country.

EFFECTIVE DATE: October 1, 2007

36 — ADMINISTRATION OF MEDICATION IN SCHOOLS BASED ON OPTOMETRISTS' WRITTEN ORDERS

The act allows school nurses and others authorized to administer medications to students to administer them pursuant to an optometrist's written order.

EFFECTIVE DATE: July 1, 2007

37 — BLOOD SAMPLE TAKING BY EMERGENCY MEDICAL TECHNICIANS (EMT)

The act deletes EMTs II from the list of those who can take a blood sample following a motor vehicle accident resulting in serious injury or death.

EFFECTIVE DATE: July 1, 2007

38 — CHRONIC DISEASE HOSPITALS

The act increases, from 24 to 36 hours, the time within which a physician must examine a person admitted to a chronic disease hospital for psychiatric treatment on a 15-day emergency certificate. (PA 07-49 imposed the 24-hour period. )

EFFECTIVE DATE: October 1, 2007

39 — DPH DISCIPLINARY ACTION AGAINST HEALTH PROFESSIONALS

The act adds to DPH's disciplinary authority over licensed health practitioners the ability to not renew or reinstate a license or permit by voluntary surrender or agreement.

EFFECTIVE DATE: Upon passage

40 — STEM CELL RESEARCH PEER REVIEW COMMITTEE

Beginning July 1, 2007, the act allows the DPH commissioner to appoint additional members to the Stem Cell Peer Review Committee as he deems necessary to review grant applications. The total number of members cannot exceed 15. These additional members must be approved according to the requirements of existing law, but they serve two-year instead of four-year terms.

EFFECTIVE DATE: July 1, 2007

41 — PHYSICIAN ASSISTANTS-USE OF TITLE, LICENSE FRAUD

The act establishes penalties for someone buying, selling, or fraudulently obtaining any diploma or license to practice as a physician assistant. It also applies to using titles or words that induce the belief that a person is practicing as a physician assistant without complying with the law on physician assistant licensure. The act establishes a fine of up to $500 or imprisonment up to five years, or both. It specifies that failure to timely renew a license is not a violation for these purposes.

EFFECTIVE DATE: July 1, 2007

42 — CONTINUING EDUCATION FOR PHYSICAL THERAPISTS

The act specifies that qualifying continuing education activities for physical therapists include courses offered or approved by the American Physical Therapy Association or any of its components; a hospital, or other licensed health care institution; or a regional accredited higher education institution.

EFFECTIVE DATE: July 1, 2007

43 & 44 — RADIOGRAPHERS, RADIOLOGIC TECHNOLOGISTS

The law allows licensed radiographers to operate a medical x-ray system under the supervision and upon the written order of a physician. The act also allows operation of such a system upon the verbal order of a physician. It also allows licensed radiologic technologists to administer any medications, not just intravenous ones, for diagnostic procedures in various health care settings, not just hospitals.

EFFECTIVE DATE: Upon passage

45 — GRADUATE DENTAL TRAINING

Existing law allows applicants for dental licensure, in lieu of a practical examination, to submit evidence of successful completion of at least one year of graduate dental training in an accredited program. The supervising dentist must provide satisfactory documentation to DPH at the end of that year.

The act allows the dental residency program director at the training facility to provide the documentation at any time rather than at the end of the year of the graduate training.

EFFECTIVE DATE: Upon passage

46 — OFFICE OF ORAL PUBLIC HEALTH

The act establishes, within DPH, an Office of Oral Public Health under the direction of an experienced public health dentist. The office must coordinate and direct state activities concerning state and national dental public health programs; serve as DPH's chief advisor on oral health; and plan, implement and evaluate all DPH oral health programs.

EFFECTIVE DATE: July 1, 2007

47 — PROFESSIONAL COUNSELORS

For purposes of meeting graduate educational requirements for licensure as a professional counselor, the act recognizes coursework at a regionally accredited institution in the following areas: (1) human growth and development, (2) social and cultural foundations, (3) counseling theories and techniques or helping relationships, (4) group dynamics, (5) processing and counseling, (6) career and lifestyle development, (7) appraisals or tests and measurements for individuals and groups, (8) research and evaluation, and (9) professional orientation to counseling. These replace references in prior law to the core and clinical curriculum of the Council for Accreditation of Counseling and Related Educational Programs and preparation in principles of etiology, diagnosis, treatment planning, and prevention of mental and emotional disorders and dysfunctional behavior. The act also deletes a requirement that acceptable graduate semester hours must be deemed to be in or related to counseling by the National Board for Certified Counselors. (PA 07-5, JSS, 67 eliminates a requirement of current law that certain applicants for a counselor license have a sixth-year degree in the discipline of counseling).

EFFECTIVE DATE: Upon passage

48 — VETERINARIANS

The act specifies that graduates of foreign veterinary schools must graduate from a program acceptable to the American Veterinary Medical Association as required to receive certification by the Educational Commission for Foreign Veterinary Graduates.

EFFECTIVE DATE: Upon passage

49 — MASSAGE THERAPISTS

The act directs the DPH commissioner, within available appropriations, to enforce provisions of the law, including PA 07-35, concerning use of the title of “massage therapist” and related titles and advertising of massage therapy services.

EFFECTIVE DATE: Upon passage

50 — REPLACEMENT BIRTH CERTIFICATES

The act requires DPH to create a replacement birth certificate according to a court order within 45 days of the order or 45 days after the child's birth, whichever is later. Prior law required DPH to do this within 45 days of the court order.

EFFECTIVE DATE: Upon passage

51-54 — RECORDING OF INSTRUMENTS BY TOWN CLERKS

Under prior law, a town clerk had to make a note on a recorded judgment lien indicating it has been released when a legally sufficient release is recorded on the land records. The act specifies that a manual notation of such release is not required if the town clerk notes the release electronically by means of a computerized notation that links the release to the recorded judgment lien.

By law, when a mortgage release or assignment is recorded, a town clerk must make a notation on the first page where a mortgage or lien is recorded, stating the book and page where the release, partial release, or assignment is recorded. The act eliminates a provision that if a town's land records are not maintained in a paper form, the town clerk may make the notation on the digitized image of the first page of the mortgage or lien in a form or manner the Public Records Administrator approves. The act instead specifies that a manual notation is not required if the town clerk notes the release or assignment electronically by means of a computerized notation that links the release to the recorded mortgage or lien.

The act requires that each instrument that is to be recorded in the land records have a return address and addressee at the top of the front side of its first page. It also requires that each page of such an instrument have a blank margin at least . 75 inches wide.

But the act prohibits a town clerk from refusing to receive an instrument for recording that does not conform to these requirements. It specifies that the fact that the town clerk records a nonconforming instrument does not affect its priority or validity.

EFFECTIVE DATE: July 1, 2007, except for the format requirements, which are effective October 1, 2008.

55-56 — PRESERVATION OF HISTORIC DOCUMENTS; ELECTRONIC INDEXING AND PUBLIC ACCESS

Under existing law, town clerks must collect a $3 fee in addition to those the law already requires them to collect for recording land documents for the purpose of generating funds for preserving and managing historic documents. The town clerks must keep $1 and remit $2 to the state treasurer for deposit in a dedicated, nonlapsing General Fund account for historic document preservation.

The act amends the definition of “preservation and management of historic documents” to allow towns to use their portion of these funds to provide public access to an electronic indexing system combining the grantor index and grantee index of a town's land records. The law already allows towns to use the funds to:

1. restore and conserve land records, land record indexes, maps, or other records;

2. microfilm these documents;

3. manage and track historic documents using information technology;

4. assess or upgrade facilities where records are retained;

5. recover documents after a disaster; and

6. train staff to maintain and track historic documents.

By January 1, 2009, the act requires each town to provide public access to an electronic indexing system combining the grantor and grantee indexes of a town's land records.

EFFECTIVE DATE: July 1, 2007

57 — ATHLETIC TRAINERS

The act allows DPH to issue a temporary permit to practice athletic training to those applicants who have met all of the license requirements except that they have not yet taken or received the results of the certification examination of the Board of Certification Inc. , or its successor organization. The act establishes a $50 fee for this. The temporary permit allows athletic trainers to practice under the supervision of a licensed athletic trainer and is limited to settings where the supervisor is physically present and immediately available to give assistance and supervision as needed. The temporary permit is valid for 120 days and cannot be renewed. It becomes void and cannot be reissued if the permittee fails to pass the certification examination.

A permit cannot be issued to a person who has previously failed the certification examination or is the subject of an unresolved complaint or pending disciplinary action. Violating these restrictions can constitute a basis for denial of an athletic trainer license.

EFFECTIVE DATE: October 1, 2007

58 — DENTISTS AND CONSCIOUS SEDATION

The act specifies that “conscious sedation” as used in the dentistry statutes does not include the administration of a single oral sedative or analgesic medication in a dose appropriate for the unsupervised treatment of insomnia, anxiety, or pain that does not exceed the maximum recommended therapeutic dose established by the federal Food and Drug Administration for unmonitored home use.

EFFECTIVE DATE: July 1, 2007

59 — FARMERS' MARKET PRODUCE SALES TO RESTAURANTS

The act permits sellers at Department of Agriculture-certified farmers' markets to sell unprocessed fruits and vegetables directly to restaurants and other food service establishments. It requires food service establishments to ask for, and the farmer or person selling the produce to provide, an invoice indicating the source of the produce and the date it was sold.

EFFECTIVE DATE: Upon passage

60 & 61 — ALZHEIMER'S SPECIAL CARE UNITS - NURSE'S AIDE TRAINING

The act requires each Alzheimer's special care unit or program to annually provide at least eight hours of Alzheimer's- and dementia- specific training, including pain recognition and administration of pain management techniques, to all nurse's aides who provide direct patient care to residents in the special unit or program. For staff hired on or after October 1, 2007, the training must be completed within six months of their date of employment. Existing law requires such training for all licensed and registered direct care staff providing direct patient care to residents of Alzheimer's special care units or programs. (The act amends PA 07-34, which requires Alzheimer's special care units or programs annually to provide at least one hour of Alzheimer's- and dementia- specific training to all unlicensed and unregistered staff. )

EFFECTIVE DATE: October 1, 2007

62 — “A BETTER CHANCE” HOUSING

The act exempts from DCF licensing requirements houses in which students participating in “A Better Chance” programs live. These programs bring academically talented minority students from other states to live and attend school in Connecticut.

EFFECTIVE DATE: July 1, 2007

63-72 — MOBILE FIELD HOSPITAL

The act changes the name of the facility the governor can deploy for public health emergencies from “critical access” to “mobile field” hospital. A “critical access hospital” is a facility that meets specified federal criteria (including rural location and provision of 24-hour emergency care), which Connecticut's facility does not.

The act adds providing medical services at mass gatherings and surge capacity during mass casualty events or infrastructure failures to the purposes for which the hospital can be used. The facility could already be used for isolation care and treatment during a public health or other emergency, triage and treatment during a mass casualty event, and training. The act also specifies that the facility must be modular and transportable.

The act specifies that licensed and certified ambulances can transport patients to the mobile field hospital (and be paid for doing so) when the governor or her designee has deployed it for an allowable purpose.

EFFECTIVE DATE: Upon passage

73-75 — PHARMACY PRACTICE

The act allows the consumer protection (DCP) and public health commissioners to (1) exchange information relating to a license or registration issued by their respective agencies or (2) exchange investigative information concerning violations of the law with each other, the Chief State's Attorney, and with law enforcement agencies.

The act increases the DCP commissioner's power to discipline controlled substance registrants, including placing a registration on probation, placing conditions on the registration, and assessing a civil penalty of up to $1,000 per violation. It adds fraudulent billing practices as a sufficient cause for taking action against a registration.

It allows certain businesses that are not licensed pharmacies to use “pharmacy,” “drug,” and similar words in signs and advertisements.

EFFECTIVE DATE: October 1, 2007

76 — MARITAL AND FAMILY THERAPISTS

The act eliminates a requirement that a supervised practicum or internship for licensure as a marital and family therapist be a minimum of 12 months and completed within a 24-month period. The practicum or internship must still be completed in order to be licensed.

EFFECTIVE DATE: Upon passage

77 — UMBILICAL CORD BLOOD BANK

The act requires the DPH commissioner, by October 1, 2007, to request information from umbilical cord blood banks concerning establishing a public cord blood collection operation in Connecticut for purposes of collecting, transporting, processing, and storing cord blood units from Connecticut residents for therapeutic and research purposes. The request for information must contain provisions inquiring about the ability of the cord blood bank to:

1. establish and operate one or more collection sites in the state;

2. implement collection procedures designed to collect cord blood units reflecting the state's racial and ethnic diversity;

3. set up collection operations within six months after contract execution with the state, provided the bank is able to negotiate any necessary contracts related to the collection sites within that time period;

4. participate in the National Cord Blood Coordinating Center or similar national inventory center by listing cord blood units in a way that assures maximum use opportunity;

5. have a program providing units for research and agree to provide units unsuitable for therapeutic use to state researchers at no charge; and

6. maintain national accreditation by an organization recognized by the federal Health Resources and Services Administration.

The act requires the commissioner to submit a summary of the responses and any recommendations to the governor and Public Health Committee by January 1, 2008.

EFFECTIVE DATE: Upon passage

78 — PILOT FAMILY NURSE PRACTITIONER PROGRAM

The act makes a technical change to PA 07-219 concerning a Department of Social Services report to a legislative committee.

EFFECTIVE DATE: October 1, 2007

81 — HISTORIC DISTRICT SWIMMING POOL

The act specifies that the restoration of an existing swimming pool in Manchester's National Landmark Historic District does not have to comply with the Public Health Code or State Building Code if Manchester enters into an agreement with DPH and the Department of Public Safety, before the project starts, holding the departments harmless from any liability associated with the pool restoration, including its public use. It does not prohibit Manchester from seeking, or either department from providing, technical assistance.

EFFECTIVE DATE: Upon passage

83 — DAY CARE SERVICES IN PUBLIC SCHOOL BUILDINGS

The act allows day care centers and group day care homes that provide services exclusively to school-age children in a public school building to ask DPH for a variance from its regulations governing physical plant requirements. Before DPH can approve a variance, it requires the center or home to (1) document that it will satisfactorily meet the regulation's specific intent by other means and (2) enter a written agreement with DPH specifying the variance, its duration, and the terms under which it is granted. The variance is cancelled immediately if the home or center fails to comply with the agreement.

The day care operator must post the variance near its license and, when a child enrolls and annually thereafter, notify the child's parents or guardian of the variance. The notice must include the DPH requirements for which the variance was granted and an explanation of how the variance will achieve the requirements' intent in a way that protects the children's health and safety.

EFFECTIVE DATE: Upon passage

84 — WOMEN, INFANTS AND CHILDREN (WIC) ADVISORY COUNCIL

The act creates an 11-member council to advise DPH on issues pertaining to increased participation in, and access to, WIC supplemental food services. The council consists of (1) the Public Health Committee chairpersons; (2) the DPH commissioner or designee; (3) the Children's Commission executive director or designee; (4) a nutrition educator, appointed by the governor; (5) two local directors of the WIC program, one appointed by the Senate president pro tempore and the other by the House speaker; (6) two WIC program recipients, one appointed by the Senate majority leader and the other by the House majority leader; and (7) two anti-hunger association representatives, one appointed by the Senate minority leader and the other by the House minority leader.

Members serve two-year terms, elect the chairperson and vice-chairperson, meet twice a year, and serve without compensation. Vacancies are filled by the appointing authority.

EFFECTIVE DATE: October 1, 2007

86 — SALE OF WATER COMPANY LAND

Under the act, a public auction or other procedure for public sale is not required for the sale or other disposition of real property by a water company to the state, a municipality, or land conservation organization if (1) at least 70% of the area of the real property sold or disposed of is to be used for open space or recreational purposes and (2) the consideration received is not less than the appraised value of the property.

EFFECTIVE DATE: July 1, 2007

87 & 88 — YOUTH CAMPS AND DAY CARE PROVIDERS

The act amends PA 07-129 to (1) make clear that any regularly scheduled program or organized group activity that advertises itself as a camp or operates only during school vacations or on weekends must be licensed as a youth camp and (2) remove a licensure exemption for programs that operate at times other than during school vacations and weekends. And, by eliminating a prior exclusion, it requires 4-H programs that offer child care services to be licensed as child day care centers or group day care homes.

EFFECTIVE DATE: September 1, 2007 for the youth camp provision; October 1, 2007 for the day care provision.

89 — TOBACCO AND HEALTH TRUST FUND

For FYs 08 and 09, the act allocates to the Department of Mental Health and Addiction Services (DMHAS) any balance remaining in the Tobacco and Health Trust Fund after transfers required by law have been made from the amount distributed to the fund from the Tobacco Settlement Fund. DMHAS must use the funds to provide grants for tobacco education programs designed to discourage smoking by minors in grades one through eight. DMHAS must ensure that these programs are funded state-wide and must establish reporting requirements. (PA 07-2, June Special Session, repealed this provision. )

EFFECTIVE DATE: July 1, 2007

90 — REPEALERS

The act eliminates a requirement that a clinical practice performing in-vitro fertilization, gamete intra-fallopian transfer, or zygote intra-fallopian transfer procedures covered by insurance report certain information to DPH. It repeals a statute concerning grants to municipalities for a one-time mass mailing of the U. S. Surgeon General's AIDS report. Finally, it repeals a statute requiring DPH to adopt regulations concerning medical test unit operations.

EFFECTIVE DATE: October 1, 2007

OLR Tracking: JK: JR: JL: TS