Connecticut Seal

General Assembly

 

Raised Bill No. 6678

January Session, 2009

 

LCO No. 4686

 

*04686_______PH_*

Referred to Committee on Public Health

 

Introduced by:

 

(PH)

 

AN ACT CONCERNING REVISIONS TO DEPARTMENT OF PUBLIC HEALTH LICENSING STATUTES.

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

Section 1. Subsection (b) of section 19a-91 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(b) (1) No licensed embalmer or funeral director shall remove a dead human body from the place of death to another location for preparation until the body has been temporarily wrapped. If the body is to be transported by common carrier, the licensed embalmer or funeral director having charge of the body shall have the body washed or embalmed unless it is contrary to the religious beliefs or customs of the deceased person, as determined by the person who assumes custody of the body for purposes of burial, and then enclosed in a casket and outside box or, in lieu of such double container, by being wrapped.

(2) Any deceased person who is to be entombed in a crypt or mausoleum shall be in a casket that is sealed in a zinc-lined or an acrylonitrile butadiene styrene (ABS) sheet plastic container or, if permitted by the cemetery where the disposition of the body is to be made, a nonoxiding metal or ABS plastic sheeting tray.

Sec. 2. Subsection (b) of section 19a-517 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(b) The department may take action under section 19a-17 for any of the following reasons: (1) The license holder has employed or knowingly cooperated in fraud or material deception in order to obtain his license or has engaged in fraud or material deception in the course of professional services or activities; (2) the license holder is suffering from physical or mental illness, emotional disorder or loss of motor skill, including but not limited to, deterioration through the aging process, or is suffering from the abuse or excessive use of drugs, including alcohol, narcotics or chemicals; (3) illegal incompetent or negligent conduct in his practice; (4) violation of any provision of state or federal law governing the license holder's practices within a nursing home; or [(4)] (5) violation of any provision of this chapter or any regulation adopted hereunder. The Commissioner of Public Health may order a license holder to submit to a reasonable physical or mental examination if his physical or mental capacity to practice safely is being investigated. Said commissioner may petition the superior court for the judicial district of Hartford to enforce such order or any action taken pursuant to section 19a-17.

Sec. 3. Subsection (a) of section 20-11a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(a) No person shall participate in an intern or resident physician program or United States medical officer candidate training program until such person has received a permit issued by the Department of Public Health. The permit shall be issued solely for purposes of participation in graduate education as an intern, resident or medical officer candidate in a hospital or hospital-based program. No person shall receive a permit until a statement has been filed with the department on the applicant's behalf by the hospital administrator certifying that the applicant is to be appointed an intern, resident or medical officer candidate in the hospital or hospital-based program and that the applicant has received the degree of doctor of medicine, osteopathic medicine or its equivalent and, if educated outside the United States or Canada (1) has successfully completed all components of a "fifth pathway program" conducted by an American medical school accredited by the Liaison Committee on Medical Education or the American Osteopathic Association, (2) received certification from the Educational Commission for Foreign Medical Graduates, (3) has successfully completed the examination for licensure prescribed by the department pursuant to section 20-10, or (4) holds a current valid license in another state or territory. Upon termination from an internship or medical residency program, a person's privileges under this subsection shall cease, such person's permit shall be automatically revoked and, if such person acts in violation of this chapter, such person shall be subject to disciplinary action pursuant to section 19a-17.

Sec. 4. Subdivision (2) of subsection (a) of section 20-126l of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(2) "Public health facility" means an institution, as defined in section 19a-490, a community health center, a group home, a school, a preschool operated by a local or regional board of education or a head start program or a program offered or sponsored by the federal Special Supplemental Food Program for Women, Infants and Children.

Sec. 5. Subsections (a) and (b) of section 19a-436 of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(a) No person shall permit, maintain, promote, conduct, advertise, act as entrepreneur, undertake, organize, manage or sell or give tickets to an actual or reasonably anticipated assembly of [three] one thousand or more people which continues or can reasonably be expected to continue for [eighteen] eight or more consecutive hours, whether on public or private property, unless a license to hold the assembly has first been issued by the chief of police of the municipality in which the assembly is to gather or, if there is none, the first selectman. A license to hold an assembly issued to one person shall permit any person to engage in any lawful activity in connection with the holding of the licensed assembly.

(b) A separate license shall be required for each day and each location in which [three] one thousand or more people assemble or can reasonably be anticipated to assemble. The fee for each license shall be one hundred dollars.

Sec. 6. Section 19a-438 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(a) Application for a license to hold an actual or anticipated assembly of [three] one thousand or more persons shall be made in writing to the governing body of the municipality at least thirty days in advance of such assembly and shall be accompanied by the bond required by subparagraph (L) of subdivision (2) of section 19a-437 and the license fee required by subsection (b) of section 19a-436, as amended by this act.

(b) The application shall contain a statement made upon oath or affirmation that the statements contained therein are true and correct to the best knowledge of the applicant and shall be signed and sworn to or affirmed by the individual making application in the case of an individual, by all officers in the case of a corporation, by all partners in the case of a partnership or by all officers of an unincorporated association, society or group or, if there are no officers, by all members of such association, society or group.

(c) The application shall contain and disclose: (1) The name, age, residence and mailing address of all persons required to sign the application by subsection (b) of this section and, in the case of a corporation, a certified copy of the articles of incorporation together with the name, age, residence and mailing address of each person holding ten per cent or more of the stock of such corporation; (2) the address and legal description of all property upon which the assembly is to be held, together with the name, residence and mailing address of the record owner or owners of all such property; (3) proof of ownership of all property upon which the assembly is to be held or a statement made upon oath or affirmation by the record owner or owners of all such property that the applicant has permission to use such property for an assembly of [three] one thousand or more persons; (4) the nature or purpose of the assembly; (5) the total number of days or hours during which the assembly is to last; (6) the maximum number of persons which the applicant shall permit to assemble at any time, not to exceed the maximum number which can reasonably assemble at the location of the assembly, in consideration of the nature of the assembly or the maximum number of persons allowed to sleep within the boundaries of the location of the assembly by the zoning ordinances of the municipality if the assembly is to continue overnight; (7) the maximum number of tickets to be sold, if any; (8) the plans of the applicant to limit the maximum number of people permitted to assemble; (9) the plans for supplying potable water including the source, amount available and location of outlets; (10) the plans for providing toilet and lavatory facilities, including the source, number, location and type, and the means of disposing of waste deposited; (11) the plans for holding, collecting and disposing of solid waste material; (12) the plans to provide for medical facilities, including the location and construction of a medical structure, the names and addresses and hours of availability of physicians and nurses, and provisions for emergency ambulance service; (13) the plans, if any, to illuminate the location of the assembly, including the source and amount of power and the location of lamps; (14) the plans for parking vehicles, including size and location of lots, points of highway access and interior roads, including routes between highway access and parking lots; (15) the plans for telephone service, including the source, number and location of telephones; (16) the plans for camping facilities, if any, including facilities available and their location; (17) the plans for security, including the number of guards, their deployment, and their names, addresses, credentials and hours of availability; (18) the plans for fire protection, including the number, type and location of all protective devices including alarms and extinguishers, and the number of emergency fire personnel available to operate the equipment; (19) the plans for sound control and sound amplification, if any, including the number, location and power of amplifiers and speakers; (20) the plans for food concessions and concessioners who will be allowed to operate on the grounds including the names and addresses of all concessioners and their license or permit numbers.

Sec. 7. Section 19a-72 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

[The Connecticut Tumor Registry shall include in its information center an occupational history of each newly diagnosed and reported cancer patient in the state, beginning January 1, 1981. Instructions for generating and including such an occupational history shall be provided by the Department of Public Health to each tumor registrar by October 1, 1980.]

(a) As used in this section:

(1) "Clinical laboratory" means any facility or other area used for microbiological, serological, chemical, hematological, immunohematological, biophysical, cytological, pathological or other examinations of human body fluids, secretions, excretions or excised or exfoliated tissues, for the purpose of providing information for the diagnosis, prevention or treatment of any human disease or impairment, for the assessment of human health or for the presence of drugs, poisons or other toxicological substances;

(2) "Hospital" means an establishment for the lodging, care and treatment of persons suffering from disease or other abnormal physical or mental conditions and includes inpatient psychiatric services in general hospitals;

(3) "Health care provider" means any person or organization that furnishes health care services and is licensed or certified to furnish such services pursuant to chapters 370, 372, 373, 375 to 384a, inclusive, 388, 398 and 399 or is licensed or certified pursuant to chapter 368d; and

(4) "Reportable tumor" means tumors and conditions included in the Connecticut Tumor Registry reportable list maintained by the Department of Public Health, as amended from time to time, as deemed necessary by the department.

(b) The Department of Public Health shall maintain and operate the Connecticut Tumor Registry. Said registry shall include a report of every occurrence of a reportable tumor that is diagnosed or treated in the state. Such reports shall be made to the department by any hospital, clinical laboratory and health care provider in the state. Such reports shall include, but not be limited to, information obtained from records of any person licensed as a health care provider and may include a collection of actual tissue samples and such information as the department may prescribe. Follow-up data, demographic, diagnostic, treatment and other medical information shall also be included in the report in a form and manner as the department may prescribe. The Commissioner of Public Health shall promulgate a list of required data items, which may be amended from time to time. Such reports shall include every occurrence of a reportable tumor that is diagnosed or treated during a calendar year. On or before July 1, 2010, and annually thereafter, such reports shall be submitted to the department in such manner as the department may prescribe.

(c) The Department of Public Health shall be provided such access to records of any health care provider, as the department deems necessary, to perform case finding or other quality improvement audits to ensure completeness of reporting and data accuracy consistent with the purposes of this section.

(d) The Department of Public Health may enter into a contract for the storage, holding and maintenance of the tissue samples under its control and management.

(e) The Department Of Public Health may enter into reciprocal reporting agreements with the appropriate agencies of other states to exchange tumor reports.

(f) (1) Failure by a hospital, clinical laboratory or health care provider to comply with the reporting requirements prescribed in this section may result in the department electing to perform the registry services for such hospital, clinical laboratory or provider. In such case, the hospital, clinical laboratory or provider shall reimburse the department for actual expenses incurred in performing such services.

(2) Any hospital, clinical laboratory or health care provider that fails to comply with the provisions of this section shall be liable to a civil penalty not to exceed five hundred dollars for each failure to disclose a reportable tumor, as determined by the commissioner.

(3) A hospital, clinical laboratory or health care provider that fails to report cases of cancer as required in regulations adopted pursuant to section 19a-73 by a date that is not later than six months after the date of a confirmed diagnosis shall be assessed a civil penalty not to exceed one thousand dollars per business day, for each day thereafter that the report is not submitted and ordered to comply with the terms of this subsection by the Commissioner of Public Health.

(g) The Commissioner of Public Health may request that the Attorney General initiate an action to collect any civil penalties assessed pursuant to this section and obtain such orders as necessary to enforce any provision of this section.

Sec. 8. (NEW) (Effective October 1, 2009) (a) As used in this section:

(1) "Health care provider" means any person that furnishes health care services and is licensed or certified to furnish such services pursuant to chapters 370 to 373 of the general statutes, inclusive, 375 to 384a, inclusive, 388, 398 and 399 of the general statutes or is licensed or certified pursuant to chapter 368d of the general statutes;

(2) "Health care facility or institution" means any facility or institution engaged primarily in providing services for the prevention, diagnosis or treatment of human health conditions, including, but not limited to: (A) Outpatient clinics; (B) outpatient surgical facilities; (C) imaging centers; (D) home health agencies and mobile field hospitals, as defined in section 19a-490 of the general statutes; (E) clinical laboratory or central service facilities serving one or more health care facilities, practitioners or institutions; (F) hospitals; (G) nursing homes; (H) rest homes; (I) nonprofit health centers; (J) diagnostic and treatment facilities; (K) rehabilitation facilities; and (L) mental health facilities. "Health care facility or institution" includes any parent company, subsidiary, affiliate or joint venture, or any combination thereof, of any such facility or institution, but does not include any health care facility operated by a nonprofit educational institution solely for the students, faculty and staff of such institution and their dependents, or any Christian Science sanatorium operated or listed and certified by the First Church of Christ, Scientist, Boston, Massachusetts, including a state health care facility or institution.

(b) Any health care provider who works at a health care facility and who provides direct patient care shall be required to wear an identification badge that indicates such provider's name and the type of license or certificate that the provider holds. A health care facility shall develop policies concerning the size and content of the identification badge required pursuant to this subsection.

Sec. 9. Section 38a-1051 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) Whereas the General Assembly finds that: (1) Equal enjoyment of the highest attainable standard of health is a human right and a priority of the state, (2) research and experience demonstrate that inhabitants of the state experience barriers to the equal enjoyment of good health based on race, ethnicity, gender, national origin and linguistic ability, and (3) addressing such barriers, and others that may arise in the future, requires: The collection, analysis and reporting of information, the identification of causes, and the development and implementation of policy solutions that address health disparities while improving the health of the public as a whole therefore, there is established a Commission on Health Equity with the mission of eliminating disparities in health status based on race, ethnicity, gender and linguistic ability, and improving the quality of health for all of the state's residents. Such commission shall consist of the following commissioners, or their designees, and public members: (A) The Commissioners of Public Health, Mental Health and Addiction Services, Developmental Services, Social Services, Correction, Children and Families, and Education; (B) the dean of The University of Connecticut Health Center, or his designee; (C) the director of The University of Connecticut Health Center and Center for Public Health and Health Policy, or their designees; (D) the dean of the Yale University Medical School, or his designee; (E) the dean of Public Health and the School of Epidemiology at Yale University, or his designee; (F) one member appointed by the president pro tempore of the Senate, who shall be a member of an affiliate of the National Urban League; (G) one member appointed by the speaker of the House of Representatives, who shall be a member of the National Association for the Advancement of Colored People; (H) one member appointed by the majority leader of the House of Representatives, who shall be a member of the Black and Puerto Rican Caucus of the General Assembly; (I) one member appointed by the majority leader of the Senate with the advice of the Native American Heritage Advisory Council or the chairperson of the Indian Affairs Council, who shall be a representative of the Native American community; (J) one member appointed by the minority leader of the Senate, who shall be a representative of an advocacy group for Hispanics; (K) one member appointed by the minority leader of the House of Representatives, who shall be a representative of the state-wide Multicultural Health Network; (L) the chairperson of the African-American Affairs Commission, or his or her designee; (M) the chairperson of the Latino and Puerto Rican Affairs Commission, or his or her designee; (N) the chairperson of the Permanent Commission on the Status of Women, or his or her designee; (O) the chairperson of the Asian Pacific American Affairs Commission, or his or her designee; (P) the director of the Hispanic Health Council, or his or her designee; (Q) the chairperson of the Office of the Healthcare Advocate, or his or her designee; and (R) eight members of the public, representing communities facing disparities in health status based on race, ethnicity, gender and linguistic ability, who shall be appointed as follows: Two by the president pro tempore of the Senate, two by the speaker of the House of Representatives, two by the minority leader of the Senate, and two by the minority leader of the House of Representatives. Vacancies on the council shall be filled by the appointing authority.

(b) The commission shall elect a chairperson and a vice-chairperson from among its members. Any member absent from either: (1) Three consecutive meetings of the commission, or (2) fifty per cent of such meetings during any calendar year, shall be deemed to have resigned from the commission.

(c) Members of the commission shall serve without compensation, but within available appropriations, and shall be reimbursed for expenses necessarily incurred in the performance of their duties.

(d) The commission shall meet as often as necessary as determined by the chairperson or a majority of the commission, but not less than at least once per calendar quarter.

(e) The commission shall: (1) Review and comment on any proposed state legislation and regulations that would affect the health of populations in the state experiencing racial, ethnic, cultural or linguistic disparities in health status, (2) review and comment on the Department of Public Health's health disparities performance measures, (3) advise and provide information to the Governor and the General Assembly on the state's policies concerning the health of populations in the state experiencing racial, ethnic, cultural or linguistic disparities in health status, (4) work as a liaison between populations experiencing racial, ethnic, cultural or linguistic disparities in health status and state agencies in order to eliminate such health disparities, (5) evaluate policies, procedures, activities and resource allocations to eliminate health status disparities among racial, ethnic and linguistic populations in the state and have the authority to convene the directors and commissioners of all state agencies whose purview is relevant to the elimination of health disparities, including but not limited to, the Departments of Public Health, Social Services, Children and Families, Developmental Services, Education, Mental Health and Addiction Services, Labor, Transportation, the Housing Finance Authority and the Office of Health Care Access for the purpose of advising on and directing the implementation of policies, procedures, activities and resource allocations to eliminate health status disparities among racial, ethnic and linguistic populations in the state, (6) prepare and submit to the Governor and General Assembly an annual report, in accordance with section 11-4a, that provides both a retrospective and prospective view of health disparities and the state's efforts to ameliorate identifiable disparities among populations of the state experiencing racial, ethnic, cultural or linguistic disparities in health status, (7) explore other successful programs in other sectors and states, and pilot and provide grants for new creative programs that may diminish or contribute to the elimination of health disparities in the state and culturally appropriate health education demonstration projects, for which the commission may apply for, accept and expand public and private funding, (8) have the authority to collect and analyze government and other data regarding the health status of state inhabitants based on race, ethnicity, gender, national origin and linguistic ability, including access, services and outcomes in private and public health care institutions within the state, including, but not limited to, the data collected by the Connecticut Health Information Network, (9) have the authority to draft and recommend proposed legislation, regulations and other policies designed to address disparities in health status, and (10) have the authority to conduct hearings and interviews, and receive testimony, regarding matters pertinent to its mission.

(f) The commission may use such funds as may be available from federal, state or other sources, and may enter into contracts to carry out the provisions of this section.

(g) The commission may, within available appropriations and subject to the provisions of chapter 67, employ any necessary staff.

(h) The commission shall be within the Office of the Healthcare Advocate for administrative purposes only.

(i) The commission shall report to the Governor and the General Assembly on its findings not later than June 1, 2010.

(j) The commission shall make a determination as to whether the duties of the commission are duplicated by any other state agency, office, bureau or commission and shall include information concerning any such duplication or performance of similar duties by any other state agency, office, bureau or commission in the report described in subsection (i) of this section.

Sec. 10. (NEW) (Effective October 1, 2009) (a) As used in this section:

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

(2) "Contact hour" means a minimum of fifty minutes of continuing education activity;

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

(4) "Licensee" means any person who receives a license from the department pursuant to chapter 384 of the general statutes; and

(5) "Registration period" means the one-year period for which a license renewed in accordance with section 19a-88 of the general statutes is current and valid.

(b) Except as otherwise provided in this section, for registration periods beginning on and after July 1, 2011, a licensee applying for license renewal shall earn a minimum of twenty-four contact hours of continuing education within the preceding twenty-four-month period. Such continuing education shall (1) be in an area of the licensee's practice; and (2) reflect the professional needs of the licensee in order to meet the veterinary health care needs of the public. Qualifying continuing education activities include, but are not limited to, courses, including on-line courses, offered or approved by national or state veterinary medical organizations, societies or associations, colleges or schools of veterinary medicine and other professional societies and organizations as appropriate to the educational needs of the licensee.

(c) Each licensee applying for license renewal pursuant to section 19a-88 of the general statutes shall sign a statement attesting that he or she has satisfied the continuing education requirements of subsection (b) of this section on a form prescribed by the department. Each licensee shall retain records of attendance or certificates of completion that demonstrate compliance with such continuing education requirements for a minimum of three years following the year in which the continuing education activities were completed and shall submit such records to the department for inspection not later than forty-five days after a request by the department for such records.

(d) A licensee applying for the first time for license renewal pursuant to section 19a-88 of the general statutes is exempt from the continuing education requirements of this section.

(e) A licensee who is not engaged in active professional practice in any form during a registration period shall be exempt from the continuing education requirements of this section, provided the licensee submits to the department, prior to the expiration of the registration period, a notarized application for exemption on a form prescribed by the department and such other documentation as may be required by the department. The application for exemption pursuant to this subsection shall contain a statement that the licensee may not engage in professional practice until the licensee has met the continuing education requirements of this section.

(f) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, along with a certification by a licensed physician of the disability or illness and such other documentation as may be required by the commissioner. The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

(g) Any licensee whose license has become void pursuant to section 19a-88 of the general statutes and who applies to the department for reinstatement of such license pursuant to section 19a-14 of the general statutes shall submit evidence documenting successful completion of twelve contact hours of continuing education within the one-year period immediately preceding application for reinstatement.

Sec. 11. Section 20-202 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

After notice and opportunity for hearing as provided in the regulations established by the Commissioner of Public Health, said board may take any of the actions set forth in section 19a-17 for any of the following causes: (1) The presentation to the board of any diploma, license or certificate illegally or fraudulently obtained; (2) proof that the holder of such license or certificate has become unfit or incompetent or has been guilty of cruelty, unskillfulness or negligence towards animals and birds; (3) conviction of the violation of any of the provisions of this chapter by any court of criminal jurisdiction, provided no license or registration shall be revoked or suspended because of such conviction if an appeal to a higher court has been filed until such appeal has been determined by the higher court and the conviction sustained; (4) the violation of any of the provisions of this chapter or the refusal to comply with any of said provisions; (5) the publication or circulation of any statement of a character tending to deceive or mislead the public; (6) the supplying of drugs, biologics, instruments or any substances or devices by which unqualified persons may practice veterinary medicine, surgery and dentistry, except that such drugs, biologics, instruments, substances or devices may be supplied to a farmer for his own animals or birds; (7) fraudulent issue or use of any health certificate, vaccination certificate, test chart or other blank form used in the practice of veterinary medicine relating to the dissemination of animal disease, transportation of diseased animals or the sale of inedible products of animal origin for human consumption; (8) knowingly having professional association with, or knowingly employing any person who is unlawfully practicing veterinary medicine; (9) failure to keep veterinary premises and equipment in a clean and sanitary condition; (10) physical or mental illness, emotional disorder or loss of motor skill, including but not limited to, deterioration through the aging process; [or] (11) abuse or excessive use of drugs, including alcohol, narcotics or chemicals; or (12) failure to comply with the continuing education requirements prescribed in section 10 of this act. A violation of any of the provisions of this chapter by any unlicensed employee in the practice of veterinary medicine, with the knowledge of his employer, shall be deemed a violation thereof by his employer. The Commissioner of Public Health may order a license holder to submit to a reasonable physical or mental examination if his physical or mental capacity to practice safely is the subject of an investigation. Said commissioner may petition the superior court for the judicial district of Hartford to enforce such order or any action taken pursuant to section 19a-17.

Sec. 12. Subsection (b) of section 19a-323 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(b) If death occurred in this state, the death certificate required by law shall be filed with the registrar of vital statistics for the town in which such person died, if known, or, if not known, for the town in which the body was found. The Chief Medical Examiner, Deputy Chief Medical Examiner, associate medical examiner, or an authorized assistant medical examiner shall complete the cremation certificate, stating that such medical examiner has made inquiry into the cause and manner of death and is of the opinion that no further examination or judicial inquiry is necessary. The cremation certificate shall be submitted to the registrar of vital statistics of the town in which such person died, if known, or, if not known, of the town in which the body was found, or with the registrar of vital statistics of the town in which the funeral director having charge of the body is located. Upon receipt of the cremation certificate, the registrar shall authorize the cremation certificate, keep [it] such certificate on permanent record, and issue a cremation permit, except that if the cremation certificate is submitted to the registrar of the town where the funeral director is located, such certificate shall be forwarded to the registrar of the town where the person died to be kept on permanent record. A subregistrar may issue a cremation permit based upon receipt of a completed cremation certificate during the hours in which the office of the registrar of vital statistics is closed or in the event of an emergency declared by the Governor pursuant to section 19a-131 or chapter 517. All such cremation certificates upon which a permit is issued shall be forwarded by the subregistrar to the registrar of the town where the subregistrar has been appointed not later than seven days after the date of issuance of the cremation permit. The registrar shall then forward the cremation certificate to the town where the person died to be kept on permanent record. The estate of the deceased person, if any, shall pay the sum of forty dollars for the issuance of the cremation certificate or an amount equivalent to the compensation then being paid by the state to authorized assistant medical examiners, if greater, provided, the Office of the Chief Medical Examiner shall not assess any fees for costs that are associated with the cremation of a stillborn fetus. No cremation certificate shall be required for a permit to cremate the remains of bodies pursuant to section 19a-270a. When the cremation certificate is submitted to a town other than that where the person died, the registrar of vital statistics for such other town shall ascertain from the original removal, transit and burial permit that the certificates required by the state statutes have been received and recorded, that the body has been prepared in accordance with the Public Health Code and that the entry regarding the place of disposal is correct. Whenever the registrar finds that the place of disposal is incorrect, the registrar shall issue a corrected removal, transit and burial permit and, after inscribing and recording the original permit in the manner prescribed for sextons' reports under section 7-72, shall then immediately give written notice to the registrar for the town where the death occurred of the change in place of disposal stating the name and place of the crematory and the date of cremation. Such written notice shall be sufficient authorization to correct these items on the original certificate of death. The fee for a cremation permit shall be three dollars and for the written notice one dollar. The Department of Public Health shall provide forms for cremation permits, which shall not be the same as for regular burial permits and shall include space to record information about the intended manner of disposition of the cremated remains, and such blanks and books as may be required by the registrars.

Sec. 13. Subsection (g) of section 20-222 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(g) Any person, firm, partnership or corporation engaged in the funeral service business shall maintain at the address of record of the funeral service business identified on the certificate of inspection:

(1) All records relating to contracts for funeral services, prepaid funeral contracts or escrow accounts for a period of not less than [three] six years after the death of the individual for whom funeral services were provided;

(2) Copies of all death certificates, burial permits, authorizations for cremation, documentation of receipt of cremated remains and written agreements used in making arrangements for final disposition of dead human bodies, including, but not limited to, copies of the final bill and other written evidence of agreement or obligation furnished to consumers, for a period of not less than [three] six years after such final disposition; and

(3) Copies of price lists, for a period of not less than [three] six years from the last date such lists were distributed to consumers.

Sec. 14. Section 19a-175 of the general statutes is amended by adding subdivision (25) as follows (Effective October 1, 2009):

(NEW) (25) "Neonatal and pediatric specialty care transport" means the interfacility transport between licensed hospitals of a critically injured or ill neonate, infant or child by at least a basic level ambulance that meets the requirements of regulations adopted pursuant to section 19a-179, including requirements concerning medically necessary supplies and services at a level that is beyond the scope of services supplied by an emergency medical technician-paramedic.

Sec. 15. (NEW) (Effective October 1, 2009) Neonatal and pediatric specialty care transport shall be required when the patient's condition requires ongoing care that must be furnished by one or more certified or licensed health care professionals from an appropriate specialty care area of neonatology or pediatrics. Any ambulance used for neonatal and pediatric specialty care transport shall meet the requirements for a basic level ambulance, as prescribed in regulations adopted pursuant to section 19a-179 of the general statutes, and shall be supported by an individual who possesses the credentials required of a licensed registered nurse with current training and certification in Pediatric Advanced Life Support pursuant to American Heart Association standards, or from the Neonatal Resuscitation Program of the American Academy of Pediatrics, as appropriate, based on the patient's condition.

Sec. 16. Subsection (a) of section 19a-493 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2009):

(a) Upon receipt of an application for an initial license, the Department of Public Health, subject to the provisions of section 19a-491a, shall issue such license if, upon conducting a scheduled inspection and investigation, it finds that the applicant and facilities meet the requirements established under section 19a-495, provided a license shall be issued to or renewed for an institution, as defined in subsection (d), (e) or (f) of section 19a-490, only if such institution is not otherwise required to be licensed by the state. Upon receipt of an application for an initial license to establish, conduct, operate or maintain an institution, as defined in subsection (d), (e) or (f) of section 19a-490, and prior to the issuance of such license, the commissioner may issue a provisional license for a term not to exceed twelve months upon such terms and conditions as the commissioner may require. If an institution, as defined in subsections (b), (c), (d), (e) and (f) of section 19a-490, applies for license renewal and has been certified as a provider of services by the United States Department of Health and Human [Resources] Services under Medicare or Medicaid programs within the immediately preceding twelve-month period, or if an institution, as defined in subsection (b) of section 19a-490, is currently certified, the commissioner or the commissioner's designee may waive the inspection and investigation of such facility required by this section and, in such event, any such facility shall be deemed to have satisfied the requirements of section 19a-495 for the purposes of licensure. Such license shall be valid for two years or a fraction thereof and shall terminate on March thirty-first, June thirtieth, September thirtieth or December thirty-first of the appropriate year. A license issued pursuant to this chapter, other than a provisional license or a nursing home license, unless sooner suspended or revoked, shall be renewable biennially after an unscheduled inspection is conducted by the department, and upon the filing by the licensee, and approval by the department, of a report upon such date and containing such information in such form as the department prescribes and satisfactory evidence of continuing compliance with requirements, and in the case of an institution, as defined in subsection (d), (e) or (f) of section 19a-490, after inspection of such institution by the department unless such institution is also certified as a provider under the Medicare program and such inspection would result in more frequent reviews than are required under the Medicare program for home health agencies. Each license shall be issued only for the premises and persons named in the application and shall not be transferable or assignable. Licenses shall be posted in a conspicuous place in the licensed premises.

Sec. 17. Subsection (d) of section 10a-34 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(d) No person, school, board, association or corporation shall operate a program or institution of higher learning unless it has been licensed or accredited by the Board of Governors of Higher Education, nor shall it confer any degree unless it has been accredited in accordance with this section. The board shall not grant any new license or accreditation until it has received a report of an evaluation of such program or institution by competent educators approved by the board. In addition, the board shall not permit any person, school, board, association or corporation to operate a program of higher learning with respect to a health care profession unless and until such time as the board receives written certification from the Commissioner of Public Health that such profession is recognized as a licensed, certified or registered health care profession under the auspices of the Department of Public Health. The Board of Governors of Higher Education shall accept regional or, where appropriate, national accreditation, in satisfaction of the requirements of this subsection unless the board finds cause not to rely upon such accreditation.

Sec. 18. Subsection (b) of section 20-10b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(b) Except as otherwise provided in subsections (d), (e) and (f) of this section, for registration periods beginning on and after October 1, 2007, a licensee applying for license renewal shall earn a minimum of fifty contact hours of continuing medical education within the preceding twenty-four-month period. Such continuing medical education shall (1) be in an area of the physician's practice; (2) reflect the professional needs of the licensee in order to meet the health care needs of the public; and (3) include at least one contact hour of training or education in each of the following topics: (A) Infectious diseases, including, but not limited to, acquired immune deficiency syndrome and human immunodeficiency virus, (B) risk management, (C) sexual assault, [and] (D) domestic violence, and (E) cultural competency. For purposes of this section, qualifying continuing medical education activities include, but are not limited to, courses offered or approved by the American Medical Association, American Osteopathic Medical Association, Connecticut Hospital Association, Connecticut State Medical Society, county medical societies or equivalent organizations in another jurisdiction, educational offerings sponsored by a hospital or other health care institution or courses offered by a regionally accredited academic institution or a state or local health department.

Sec. 19. Subsection (a) of section 20-222 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(a) No person, firm, partnership or corporation shall enter into, engage in, or carry on a funeral service business unless an inspection certificate has been issued by the department for each place of business. Any person, firm, partnership or corporation desiring to engage in the funeral service business shall submit, in writing, to the department an application upon blanks furnished by the department for an inspection certificate for a funeral service business for each place of business, and each such application shall be accompanied by a fee of three hundred dollars and shall identify the manager. Each holder of an inspection certificate shall, annually, on or before July first, submit in writing to the Department of Public Health an application for renewal of such certificate together with a fee of one hundred fifty dollars. If the Department of Public Health issues to such applicant such an inspection certificate, the same shall be valid until July first next following, unless revoked or suspended. Nothing in this subsection shall be construed to prohibit an institution of higher learning that operates a program in mortuary science that has been accredited by the Board of Governors of Higher Education in accordance with the provisions of section 10a-34, as amended by this act, from installing working preparation embalming rooms.

Sec. 20. Section 7-66 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

The sexton of a cemetery shall specify on the burial permit the place of burial, by section, lot or grave, or other place of interment. No additional burial or removal, transit and burial permit shall be required for a body that is placed temporarily in a receiving vault of any cemetery and subsequently buried in the same cemetery. In each case herein provided for, the sexton of such cemetery shall endorse upon the burial permit the date when the body was placed in the temporary receiving vault, and the date when and the place where such body was subsequently buried. The sexton shall also include a statement of the same in the monthly returns to the registrar of vital statistics. [The] Not later than thirty days after the date of burial, the sexton shall send a copy of the endorsed removal, transit and burial permit, or the permit for final disposition if the death occurred in another state, to the registrar of vital statistics who filed the death certificate for the body for which said removal, transit and burial permit was issued. Any removal, transit and burial permit shall conspicuously note: "A copy of this removal, transit and burial permit upon endorsement by the sexton shall be returned to the registrar of vital statistics of the town where the death occurred.". For those deaths occurring in this state, a copy of the endorsed burial permit or removal, transit and burial permit shall be attached to the original death certificate. If such subsequent burial is to be in any cemetery other than the cemetery where the body was temporarily deposited or if the body is to be cremated, the sexton shall return the burial permit to the issuing registrar, who shall thereupon issue the necessary permits. Any person who violates any provision of this section shall be fined not more than five hundred dollars or imprisoned not more than five years.

Sec. 21. Subsection (c) of section 19a-91 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

(c) In addition to the requirements set forth in subsection (b) of this section, (1) in the case of death resulting from a disease on the current list of reportable diseases developed pursuant to section 19a-36-A2 of the regulations of Connecticut state agencies, the licensed embalmer or funeral director having charge of the dead human body shall prepare such body for burial or cremation by having the body washed, embalmed or wrapped as soon as practicable after the body arrives at the licensed embalmer's or licensed funeral director's place of business. The provisions of this [subsection do] subdivision shall not apply if death is not the result of a disease on the current list of reportable diseases developed pursuant to section 19a-36-A2 of the regulations of Connecticut state agencies, provided the licensed embalmer or funeral director having charge of the body takes appropriate measures to ensure that the body does not pose a threat to the public health; and (2) the body of any deceased whose death is not the result of a disease on the current list of reportable diseases developed pursuant to section 19a-36-A2 of the regulations of Connecticut state agencies that: (A) Shall not reach its final disposition or destination within forty-eight hours from the time of death, (B) is addressed to the demonstrator of anatomy of a medical college, or (C) is for other demonstration purposes shall be embalmed, unless embalmment is contrary to the religious beliefs of the deceased person or the deceased person is kept in a climate controlled room.

Sec. 22. Section 21a-254a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2009):

The Commissioner of Consumer Protection shall appoint a prescription drug monitoring working group for the purpose of advising the commissioner on the implementation of the electronic prescription drug monitoring program established pursuant to section 21a-254, including the adoption of regulations by the commissioner. Such advice shall include, but not be limited to, recommendations on how to effectively use the data collected pursuant to such program to detect fraud or improper prescribing of controlled substances while protecting the legitimate use of such controlled substances. The working group shall include, but not be limited to: (1) A physician, licensed pursuant to chapter 370, specializing in internal medicine; (2) a board certified oncologist; (3) a person licensed to perform advanced level nursing practice activities pursuant to subsection (b) of section 20-87a; (4) a representative from an acute care hospital licensed pursuant to chapter 368v; (5) a state police officer appointed in accordance with section 29-4; (6) a municipal police chief; (7) a representative from the Division of Criminal Justice; (8) a representative from a hospice licensed by the Department of Public Health or certified pursuant to 42 USC 1395x; (9) a pain management specialist, as defined in section 38a-492i; (10) a pharmacist licensed pursuant to section 20-590, 20-591 or 20-592; and (11) a representative from the Department of Mental Health and Addiction Services.

Sec. 23. (Effective from passage) The Commissioner of Public Health, in concurrence with the Commissioners of Consumer Protection and Environmental Protection, may issue variances to the regulations of the Connecticut state agencies to an institution of higher education that is located in a city with the population of not less than one hundred thousand, but not more than one hundred fifty thousand and within a groundwater zone that is classified by the state as GB for the installation and study of standing column geothermal wells in New Haven, Connecticut. Prior to issuing such variances, such institution of higher education shall submit such information and data as the Departments of Public Health, Environment and Consumer Protection deem necessary to ensure protection of the public health and environment. Said commissioners may require certain minimum safeguards in excess of existing regulatory requirements for such wells. In the event that operation of any geothermal well system is deemed to be injurious to the public health or environment, the Commissioner of Public Health or the Commissioner of Environmental Protection may order such system be closed down and abandoned in accordance with the regulations of Connecticut state agencies. An institution of higher education granted such variances shall engage, at such institution's expense, an independent, third-party expert, approved by the Department of Public Health, to review any data submitted to said departments for purposes of assisting said departments in developing future regulations for geothermal wells.

Sec. 24. (Effective from passage) Section 10-292p of the general statutes is repealed.

This act shall take effect as follows and shall amend the following sections:

Section 1

October 1, 2009

19a-91(b)

Sec. 2

October 1, 2009

19a-517(b)

Sec. 3

October 1, 2009

20-11a(a)

Sec. 4

October 1, 2009

20-126l(a)(2)

Sec. 5

October 1, 2009

19a-436(a) and (b)

Sec. 6

October 1, 2009

19a-438

Sec. 7

October 1, 2009

19a-72

Sec. 8

October 1, 2009

New section

Sec. 9

from passage

38a-1051

Sec. 10

October 1, 2009

New section

Sec. 11

October 1, 2009

20-202

Sec. 12

October 1, 2009

19a-323(b)

Sec. 13

October 1, 2009

20-222(g)

Sec. 14

October 1, 2009

19a-175

Sec. 15

October 1, 2009

New section

Sec. 16

July 1, 2009

19a-493(a)

Sec. 17

October 1, 2009

10a-34(d)

Sec. 18

October 1, 2009

20-10b(b)

Sec. 19

October 1, 2009

20-222(a)

Sec. 20

October 1, 2009

7-66

Sec. 21

October 1, 2009

19a-91(c)

Sec. 22

October 1, 2009

21a-254a

Sec. 23

from passage

New section

Sec. 24

from passage

Repealer section

Statement of Purpose:

To make various changes concerning licensing requirements applicable to health care professionals and institutions.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]