Connecticut Seal

General Assembly

Amendment

 

February Session, 2016

LCO No. 5611

   
 

*HB0553705611HDO*

Offered by:

 

REP. RITTER M. , 1st Dist.

SEN. GERRATANA, 6th Dist.

REP. SRINIVASAN, 31st Dist.

SEN. MARKLEY, 16th Dist.

 

To: Subst. House Bill No. 5537

File No. 535

Cal. No. 337

"AN ACT CONCERNING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES. "

In line 55, bracket "person" and after the closing bracket insert "individual"

In line 56, before "370" insert "368v,"

In line 57, bracket "381a" and after the closing bracket insert "381b"

In line 57, bracket "398 or 399" and after the closing bracket insert "388 or 397a to 399, inclusive"

In line 245, before "infection" insert "for registration periods beginning on and after October 1, 2016,"

In line 273, strike "but not limited to" and insert in lieu thereof "for registration periods beginning on and after October 1, 2016"

Strike section 13 and renumber the remaining sections and internal references accordingly

In line 698, strike "twenty-four hours" and insert in lieu thereof "the end of the next business day"

In line 712, insert an opening bracket before the comma

In line 713, insert a closing bracket after the comma

In line 714, strike "twenty-"

In line 715, strike "four hours" and insert in lieu thereof "the end of the next business day"

In line 782, after "physician", insert "or advanced practice registered nurse"

In line 786, after "physician" insert "or advanced practice registered nurse"

In line 788, after "physician", insert "or advanced practice registered nurse"

After the last section, add the following and renumber sections and internal references accordingly:

"Sec. 501. Subsections (a) and (b) of section 19a-492e of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) For purposes of this section "home health care agency" has the same meaning as provided in section 19a-490, as amended by this act. Notwithstanding the provisions of chapter 378, a registered nurse may delegate the administration of medications that are not administered by injection to homemaker-home health aides who have obtained certification and recertification every three years thereafter for medication administration in accordance with regulations adopted pursuant to subsection (b) of this section, unless the prescribing practitioner specifies that a medication shall only be administered by a licensed nurse.

(b) (1) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to carry out the provisions of this section. Such regulations shall require each home health care agency that serves clients requiring assistance with medication administration to (A) adopt practices that increase and encourage client choice, dignity and independence; (B) establish policies and procedures to ensure that a registered nurse may delegate allowed tasks of nursing care, to include medication administration, to homemaker-home health aides when the registered nurse determines that it is in the best interest of the client and the homemaker-home health aide has been deemed competent to perform the task; (C) designate homemaker-home health aides to obtain certification and recertification for the administration of medication; and (D) ensure that such homemaker-home health aides receive such certification and recertification.

(2) The regulations shall establish certification and recertification requirements for medication administration and the criteria to be used by home health care agencies that provide services for clients requiring assistance with medication administration in determining (A) which homemaker-home health aides shall obtain such certification and recertification, and (B) education and skill training requirements, including ongoing training requirements for such certification and recertification.

(3) Education and skill training requirements for initial certification and recertification shall include, but not be limited to, initial orientation, training in client rights and identification of the types of medication that may be administered by unlicensed personnel, behavioral management, personal care, nutrition and food safety, and health and safety in general.

Sec. 502. Subsections (a) and (b) of section 19a-495a of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) (1) The Commissioner of Public Health shall adopt regulations, as provided in subsection (d) of this section, to require each residential care home, as defined in section 19a-490, as amended by this act, that admits residents requiring assistance with medication administration, to (A) designate unlicensed personnel to obtain certification for the administration of medication, and (B) to ensure that such unlicensed personnel receive such certification and recertification every three years thereafter.

(2) The regulations shall establish criteria to be used by such homes in determining (A) the appropriate number of unlicensed personnel who shall obtain such certification and recertification, and (B) training requirements, including [on-going] ongoing training requirements for such certification and recertification.

(3) Training requirements for initial certification and recertification shall include, but shall not be limited to: Initial orientation, resident rights, identification of the types of medication that may be administered by unlicensed personnel, behavioral management, personal care, nutrition and food safety, and health and safety in general.

(b) Each residential care home, as defined in section 19a-490, as amended by this act, shall ensure that, on or before January 1, 2010, an appropriate number of unlicensed personnel, as determined by the residential care home, obtain certification and recertification for the administration of medication. Certification and recertification of such personnel shall be in accordance with regulations adopted pursuant to this section. Unlicensed personnel obtaining such certification and recertification may administer medications that are not administered by injection to residents of such homes, unless a resident's physician specifies that a medication only be administered by licensed personnel.

Sec. 503. (NEW) (Effective October 1, 2016) (a) As used in this section:

(1) "Music therapy" means the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed a music therapy program approved by the American Music Therapy Association, or any successor of said association; and

(2) "Music therapist" means a person who (A) has earned a bachelor's or graduate degree in music therapy or a related field from an accredited institution of higher education, and (B) is certified as a music therapist by the Certification Board for Music Therapists or any successor of said board.

(b) No person unless certified as a music therapist by the Certification Board for Music Therapists, or any successor of said board, may use the title "music therapist" or "certified music therapist" or make use of any title, words, letters, abbreviations or insignia indicating or implying that he or she is a certified music therapist. Any person who violates this section shall be guilty of a class D felony. For purposes of this section, each instance of contact or consultation with an individual that is in violation of any provision of this section shall constitute a separate offense.

(c) The provisions of this section shall not apply to a person who (1) is licensed, certified or regulated under the laws of this state in another profession or occupation, including, but not limited to, occupational therapy, physical therapy, speech and language pathology, audiology or counseling, or is supervised by such a licensed, certified or regulated person, and uses music in the practice of his or her licensed, certified or regulated profession or occupation that is incidental to such practice, provided the person does not hold himself or herself out to the public as a music therapist, (2) is a student enrolled in a music therapy educational program or graduate music therapy educational program approved by the American Music Therapy Association, or any successor of said association, and music therapy is an integral part of the student's course of study and such student is performing such therapy under the direct supervision of a music therapist, or (3) is a professional whose training and national certification attests to such person's ability to practice his or her certified occupation or profession and whose use of music is incidental to the practice of such occupation or profession, provided such person does not hold himself or herself out to the public as a music therapist.

Sec. 504. (NEW) (Effective October 1, 2016) (a) As used in this section:

(1) "Art therapy" means clinical and evidence-based use of art, including art media, the creative process and the resulting artwork, to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an art therapy program approved by the American Art Therapy Association, or any successor of said association; and

(2) "Art therapist" means a person who (A) has earned a bachelor's or graduate degree in art therapy or a related field from an accredited institution of higher education, and (B) is certified as an art therapist by the Art Therapy Credentials Board or any successor of said board.

(b) No person unless certified as an art therapist may use the title "art therapist" or "certified art therapist" or make use of any title, words, letters, abbreviations or insignia indicating or implying that he or she is a certified art therapist. Any person who violates this section shall be guilty of a class D felony. For purposes of this section, each instance of contact or consultation with an individual that is in violation of any provision of this section shall constitute a separate offense.

(c) The provisions of this section shall not apply to a person who (1) provides art therapy while acting within the scope of practice of the person's license and training, provided the person does not hold himself or herself out to the public as an art therapist, or (2) is a student enrolled in an art therapy educational program or graduate art therapy educational program approved by the American Art Therapy Association, or any successor of said association, and art therapy is an integral part of the student's course of study and such student is performing such therapy under the direct supervision of an art therapist.

Sec. 505. Section 8-3e of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) No zoning regulation shall treat the following in a manner different from any single family residence: (1) Any community residence that houses six or fewer persons with intellectual disability and necessary staff persons and that is licensed under the provisions of section 17a-227, (2) any child-care residential facility that houses six or fewer children with mental or physical disabilities and necessary staff persons and that is licensed under sections 17a-145 to 17a-151, inclusive, (3) any community residence that houses six or fewer persons receiving mental health or addiction services and necessary staff persons paid for or provided by the Department of Mental Health and Addiction Services and that has been issued a license by the Department of Public Health under the provisions of section 19a-491, if a license is required, or (4) any [hospice facility, including a hospice] residence [,] that provides [inpatient] licensed hospice care and services to six or fewer persons, [and is licensed to provide such services by the Department of Public Health,] provided such [facility] residence is (A) managed by an organization that is tax exempt under Section 501(c)(3) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended; (B) located in a city with a population of more than one hundred thousand and within a zone that allows development on one or more acres; [and] (C) served by public sewer and water; and (D) constructed in accordance with applicable building codes for occupancy by six or fewer persons who are not capable of self-preservation.

(b) Any resident of a municipality in which such a community residence or child-care residential facility is located may, with the approval of the legislative body of such municipality, petition (1) the Commissioner of Developmental Services to revoke the license of such community residence on the grounds that such community residence is not in compliance with the provisions of any statute or regulation concerning the operation of such residences, (2) the Commissioner of Children and Families to revoke the license of such child-care residential facility on the grounds that such child-care residential facility is not in compliance with the provision of any general statute or regulation concerning the operation of such child-care residential facility, or (3) the Commissioner of Mental Health and Addiction Services to withdraw funding from such community residence on the grounds that such community residence is not in compliance with the provisions of any general statute or regulation adopted thereunder concerning the operation of a community residence.

Sec. 506. Section 20-112a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) As used in this section:

(1) "Direct supervision" means a licensed dentist has authorized certain procedures to be performed on a patient by a dental assistant or an expanded function dental assistant with such dentist remaining on-site in the dental office or treatment facility while such procedures are being performed by the dental assistant or expanded function dental assistant and that, prior to the patient's departure from the dental office, such dentist reviews and approves the treatment performed by the dental assistant or expanded function dental assistant;

(2) "Indirect supervision" means a licensed dentist is in the dental office or treatment facility, has personally diagnosed the condition, planned the treatment, authorized the procedures to be performed and remains in the dental office or treatment facility while the procedures are being performed by the dental assistant or expanded function dental assistant and evaluates the performance of the dental assistant or expanded function dental assistant;

(3) "Dental assistant" means a person who: (A) Has (i) completed on-the-job training in dental assisting under direct supervision, (ii) successfully completed a dental assistant education program accredited by the American Dental Association's Commission on Dental Accreditation, or (iii) successfully completed a dental assistant education program that is accredited or recognized by the New England Association of Schools and Colleges; and (B) meets any requirements established by the Commissioner of Public Health in regulations adopted pursuant to subsection (f) of this section; and

(4) "Expanded function dental assistant" means a dental assistant who has passed the Dental Assisting National Board's certified dental assistant or certified orthodontic assistant examination and then successfully completed: (A) An expanded function dental assistant program at an institution of higher education that is accredited by the Commission on Dental Accreditation of the American Dental Association that includes (i) educational courses relating to didactic and laboratory preclinical objectives for skills used by an expanded function dental assistant and that requires demonstration of such skills prior to advancing to clinical practice, (ii) not less than four hours of education in the area of ethics and professional standards for dental professionals, and (iii) a comprehensive clinical examination administered by the institution of higher education at the conclusion of such program; and (B) a comprehensive written examination concerning certified preventive functions and certified restorative functions administered by the Dental Assisting National Board.

(b) Each expanded function dental assistant shall: (1) Maintain dental assistant or orthodontic assistant certification from the Dental Assisting National Board; (2) conspicuously display his or her dental assistant or orthodontic assistant certificate at his or her place of employment or place where he or she provides expanded function dental assistant services; (3) maintain professional liability insurance or other indemnity against liability for professional malpractice in an amount not less than five hundred thousand dollars for one person, per occurrence, with an aggregate liability of not less than one million five hundred thousand dollars while employed as an expanded function dental assistant; (4) provide expanded function dental assistant services only under direct or indirect supervision; and (5) meet any requirements established by the Commissioner of Public Health in regulations adopted pursuant to subsection (f) of this section.

(c) (1) A licensed dentist may delegate to dental assistants such dental procedures as the dentist may deem advisable, including: [the] (A) The taking of dental x-rays if the dental assistant can demonstrate successful completion of the dental [radiography portion of an examination prescribed] radiation health and safety examination administered by the Dental Assisting National Board; [, but such] and (B) the taking of impressions of teeth for study models. Such procedures shall be performed under [the dentist's] direct supervision [and control] and the dentist providing direct supervision shall assume responsibility for such procedures. [; provided such assistants may not]

(2) A licensed dentist may delegate to an expanded function dental assistant such dental procedures as the dentist may deem advisable, including: (A) The placing, finishing and adjustment of temporary restorations and long-term individual fillings, capping materials and cement bases; (B) oral health education for patients; (C) dental sealants; and (D) coronal polishing, provided the procedure is not represented or billed as prophylaxis. Such procedures shall be performed under the direct or indirect supervision and the dentist providing such supervision shall assume responsibility for such procedures.

(3) On or after January 1, 2018, (A) no licensed dentist may delegate dental procedures to a dental assistant or expanded function dental assistant unless the dental assistant or expanded function dental assistant provides records demonstrating successful completion of the Dental Assisting National Board's infection control examination, except as provided in subdivision (2) of this subsection, (B) a dental assistant may receive not more than nine months of on-the-job training by a licensed dentist for purposes of preparing the dental assistant for the Dental Assisting National Board's infection control examination, and (C) any licensed dentist who delegates dental procedures to a dental assistant shall retain and make such records available for inspection upon request of the Department of Public Health.

(4) On and after January 1, 2018, upon successful completion of the Dental Assisting National Board's infection control examination, each dental assistant or expanded function dental assistant shall complete not less than one hour of training or education in infection control in a dental setting every two years, including, but not limited to, courses, including online courses, offered or approved by a dental school or another institution of higher education that is accredited or recognized by the Commission on Dental Accreditation, a regional accrediting organization, the American Dental Association or a state, district or local dental association or society affiliated with the American Dental Association or the American Dental Assistants Association.

(d) Under no circumstances may a dental assistant or expanded function dental assistant engage in: (1) Diagnosis for dental procedures or dental treatment; (2) the cutting or removal of any hard or soft tissue or suturing; (3) the prescribing of drugs or medications that require the written or oral order of a licensed dentist or physician; (4) the administration of local, parenteral, inhalation or general anesthetic agents in connection with any dental operative procedure; (5) the taking of any final impression of the teeth or jaws or the relationship of the teeth or jaws for the purpose of fabricating any appliance or prosthesis; or (6) [the placing, finishing and adjustment of temporary or final restorations, capping materials and cement bases; or (7)] the practice of dental hygiene as defined in section 20-126l.

(e) Each licensed dentist employing or otherwise engaging the services of an expanded function dental assistant shall: (1) Prior to hiring or otherwise engaging the services of the expanded function dental assistant, verify that the expanded function dental assistant meets the requirements described in subdivision (4) of subsection (a) and subdivisions (1) and (3) of subsection (b) of this section; (2) maintain documentation verifying that the expanded function dental assistant meets such requirements on the premises where the expanded function dental assistant provides services; (3) make such documentation available to the Department of Public Health upon request; and (4) provide direct or indirect supervision to not more than two expanded function dental assistants who are providing services at one time or, if the dentist's practice is limited to orthodontics, provide direct or indirect supervision to not more than four expanded function dental assistants who are providing services at one time.

(f) The Commissioner of Public Health, in consultation with the State Dental Commission, established pursuant to section 20-103a, may adopt regulations in accordance with the provisions of chapter 54 to implement the provisions of this section. Such regulations, if adopted, shall include, but need not be limited to, identification of the: (1) Specific types of procedures that may be performed by a dental assistant and an expanded function dental assistant, consistent with the provisions of this section; (2) appropriate number of didactic, preclinical and clinical hours or number of procedures to be evaluated for clinical competency for each skill employed by an expanded function dental assistant; and (3) the level of supervision, that may include direct or indirect supervision, that is required for each procedure to be performed by an expanded function dental assistant.

Sec. 507. Section 19a-244 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

On and after October 1, 2010, any person nominated to be the director of health shall (1) be a licensed physician and hold a degree in public health from an accredited school, college, university or institution, or (2) hold a graduate degree in public health from an accredited school, college or institution. The educational requirements of this section shall not apply to any director of health nominated or otherwise appointed as director of health prior to October 1, 2010. The board may specify in a written agreement with such director the term of office, which shall not exceed three years, salary and duties required of and responsibilities assigned to such director in addition to those required by the general statutes or the Public Health Code, if any. [He] Such director shall be removed during the term of such written agreement only for cause after a public hearing by the board on charges preferred, of which reasonable notice shall have been given. [He shall devote his entire time to the performance of such duties as are] No director shall, during such director's term of office, have any financial interest in or engage in any employment, transaction or professional activity that is in substantial conflict with the proper discharge of the duties required of directors of health by the general statutes or the Public Health Code [and as the board specifies] or specified by the board in its written agreement with [him; and shall] such director. Such director shall serve in a full-time capacity and act as secretary and treasurer of the board, without the right to vote. [He] Such director shall give to the district a bond with a surety company authorized to transact business in the state, for the faithful performance of [his] such director's duties as treasurer, in such sum and upon such conditions as the board requires. [He] Such director shall be the executive officer of the district department of health. Full-time employees of a city, town or borough health department at the time such city, town or borough votes to form or join a district department of health shall become employees of such district department of health. Such employees may retain their rights and benefits in the pension system of the town, city or borough by which they were employed and shall continue to retain their active participating membership therein until retired. Such employees shall pay into such pension system the contributions required of them for their class and membership. Any additional employees to be hired by the district or any vacancies to be filled shall be filled in accordance with the rules and regulations of the merit system of the state of Connecticut and the employees who are employees of cities, towns or boroughs which have adopted a local civil service or merit system shall be included in their comparable grade with fully attained seniority in the state merit system. Such employees shall perform such duties as are prescribed by the director of health. In the event of the withdrawal of a town, city or borough from the district department, or in the event of a dissolution of any district department, the employees thereof, originally employed therein, shall automatically become employees of the appropriate town, city or borough's board of health.

Sec. 508. Subsection (a) of section 19a-200 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) The mayor of each city, the warden of each borough, and the chief executive officer of each town shall, unless the charter of such city, town or borough otherwise provides, nominate some person to be director of health for such city, town or borough, which nomination shall be confirmed or rejected by the board of selectmen, if there be such a board, otherwise by the legislative body of such city or town or by the burgesses of such borough within thirty days thereafter. Notwithstanding the charter provisions of any city, town or borough with respect to the qualifications of the director of health, on and after October 1, 2010, any person nominated to be a director of health shall (1) be a licensed physician and hold a degree in public health from an accredited school, college, university or institution, or (2) hold a graduate degree in public health from an accredited school, college or institution. The educational requirements of this section shall not apply to any director of health nominated or otherwise appointed as director of health prior to October 1, 2010. In cities, towns or boroughs with a population of forty thousand or more for five consecutive years, according to the estimated population figures authorized pursuant to subsection (b) of section 8-159a, such director of health shall serve in a full-time capacity, except where a town has designated such director as the chief medical advisor for its public schools under section 10-205, and shall not, [engage in private practice] during such director's term of office, have any financial interest in or engage in any employment, transaction or professional activity that is in substantial conflict with the proper discharge of the duties required of directors of health by the general statutes or the Public Health Code or specified by the appointing authority of the city, town or borough in its written agreement with such director. Such director of health shall have and exercise within the limits of the city, town or borough for which such director is appointed all powers necessary for enforcing the general statutes, provisions of the Public Health Code relating to the preservation and improvement of the public health and preventing the spread of diseases therein. In case of the absence or inability to act of a city, town or borough director of health or if a vacancy exists in the office of such director, the appointing authority of such city, town or borough may, with the approval of the Commissioner of Public Health, designate in writing a suitable person to serve as acting director of health during the period of such absence or inability or vacancy, provided the commissioner may appoint such acting director if the city, town or borough fails to do so. The person so designated, when sworn, shall have all the powers and be subject to all the duties of such director. In case of vacancy in the office of such director, if such vacancy exists for thirty days, said commissioner may appoint a director of health for such city, town or borough. Said commissioner, may, for cause, remove an officer the commissioner or any predecessor in said office has appointed, and the common council of such city, town or the burgesses of such borough may, respectively, for cause, remove a director whose nomination has been confirmed by them, provided such removal shall be approved by said commissioner; and, within two days thereafter, notice in writing of such action shall be given by the clerk of such city, town or borough, as the case may be, to said commissioner, who shall, within ten days after receipt, file with the clerk from whom the notice was received, approval or disapproval. Each such director of health shall hold office for the term of four years from the date of appointment and until a successor is nominated and confirmed in accordance with this section. Each director of health shall, annually, at the end of the fiscal year of the city, town or borough, file with the Department of Public Health a report of the doings as such director for the year preceding.

Sec. 509. Section 19a-2a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

The Commissioner of Public Health shall employ the most efficient and practical means for the prevention and suppression of disease and shall administer all laws under the jurisdiction of the Department of Public Health and the Public Health Code. The commissioner shall have responsibility for the overall operation and administration of the Department of Public Health. The commissioner shall have the power and duty to: (1) Administer, coordinate and direct the operation of the department; (2) adopt and enforce regulations, in accordance with chapter 54, as are necessary to carry out the purposes of the department as established by statute; (3) establish rules for the internal operation and administration of the department; (4) establish and develop programs and administer services to achieve the purposes of the department as established by statute; (5) enter into a contract, including, but not limited to, a contract with another state, for facilities, services and programs to implement the purposes of the department as established by statute; (6) designate a deputy commissioner or other employee of the department to sign any license, certificate or permit issued by said department; (7) conduct a hearing, issue subpoenas, administer oaths, compel testimony and render a final decision in any case when a hearing is required or authorized under the provisions of any statute dealing with the Department of Public Health; (8) with the health authorities of this and other states, secure information and data concerning the prevention and control of epidemics and conditions affecting or endangering the public health, and compile such information and statistics and shall disseminate among health authorities and the people of the state such information as may be of value to them; (9) annually issue a list of reportable diseases, emergency illnesses and health conditions and a list of reportable laboratory findings and amend such lists as the commissioner deems necessary and distribute such lists as well as any necessary forms to each licensed physician and clinical laboratory in this state. The commissioner shall prepare printed forms for reports and returns, with such instructions as may be necessary, for the use of directors of health, boards of health and registrars of vital statistics; and (10) specify uniform methods of keeping statistical information by public and private agencies, organizations and individuals, including a client identifier system, and collect and make available relevant statistical information, including the number of persons treated, frequency of admission and readmission, and frequency and duration of treatment. The client identifier system shall be subject to the confidentiality requirements set forth in section 17a-688 and regulations adopted thereunder. The commissioner may designate any person to perform any of the duties listed in subdivision (7) of this section. The commissioner shall have authority over directors of health and may, for cause, remove any such director; but any person claiming to be aggrieved by such removal may appeal to the Superior Court which may affirm or reverse the action of the commissioner as the public interest requires. The commissioner shall assist and advise local directors of health and district directors of health in the performance of their duties, and may require the enforcement of any law, regulation or ordinance relating to public health. In the event the commissioner reasonably suspects impropriety on the part of a local director of health or district director of health, or employee of such director, in the performance of his or her duties, the commissioner shall provide notification and any evidence of such impropriety to the appropriate governing authority of the municipal health authority, established pursuant to section 19a-200, or the district department of health, established pursuant to section 19a-244, for purposes of reviewing and assessing a director's or an employee's compliance with such duties. Such governing authority shall provide a written report of its findings from the review and assessment to the commissioner not later than ninety days after such review and assessment. When requested by local directors of health or district directors of health, the commissioner shall consult with them and investigate and advise concerning any condition affecting public health within their jurisdiction. The commissioner shall investigate nuisances and conditions affecting, or that he or she has reason to suspect may affect, the security of life and health in any locality and, for that purpose, the commissioner, or any person authorized by the commissioner, may enter and examine any ground, vehicle, apartment, building or place, and any person designated by the commissioner shall have the authority conferred by law upon constables. Whenever the commissioner determines that any provision of the general statutes or regulation of the Public Health Code is not being enforced effectively by a local health department or health district, he or she shall forthwith take such measures, including the performance of any act required of the local health department or health district, to ensure enforcement of such statute or regulation and shall inform the local health department or health district of such measures. In September of each year the commissioner shall certify to the Secretary of the Office of Policy and Management the population of each municipality. The commissioner may solicit and accept for use any gift of money or property made by will or otherwise, and any grant of or contract for money, services or property from the federal government, the state, any political subdivision thereof, any other state or any private source, and do all things necessary to cooperate with the federal government or any of its agencies in making an application for any grant or contract. The commissioner may establish state-wide and regional advisory councils. For purposes of this section, "employee of such director" means an employee of, a consultant employed or retained by or an independent contractor retained by a local director of health, a district director of health, a local health department or a health district.

Sec. 510. (NEW) (Effective October 1, 2016) Not later than January 1, 2017, the Commissioner of Public Health shall review the general statutes governing local health departments and districts to determine whether they need revising and submit such determination, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committee of the General Assembly having cognizance of matters relating to public health.

Sec. 511. Section 19a-6f of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

On or before January 1, [2005] 2017, and annually thereafter, the Commissioner of Public Health shall obtain from the American Association of Medical Assistants [,] and the National Healthcareer Association a listing of all state residents maintained on said [organization's] organizations' registry of certified medical assistants. The commissioner shall make such [listing] listings available for public inspection.

Sec. 512. (Effective from passage) (a) There is established a working group to consider matters relating to nail salons and the provision of services by nail technicians. Such matters may include, but need not be limited to: (1) Standards for nail salons to protect the health and safety of customers; (2) licensure or certification standards for nail technicians, including educational and training requirements for nail technicians; (3) working conditions of nail technicians; (4) fair and equitable business practices; and (5) the development of informational publications, in multiple languages as appropriate, to advise owners and managers of nail salons of applicable state laws and regulations.

(b) The working group shall consist of the following members:

(1) One appointed by the speaker of the House of Representatives, who shall be the owner of two or more nail salons in the state;

(2) One appointed by the president pro tempore of the Senate who shall have not less than two years of experience working as a nail technician;

(3) One appointed by the majority leader of the House of Representatives who shall be a representative of the Nail and Spa Association of Connecticut;

(4) One appointed by the majority leader of the Senate;

(5) One appointed by the minority leader of the House of Representatives who shall be the owner of a single nail salon employing less than five persons;

(6) One appointed by the minority leader of the Senate who shall have experience working as a nail technician; and

(7) The chairpersons of the joint standing committee of the General Assembly having cognizance of matters relating to public health, or the chairpersons' designees.

(c) Any member of the working group appointed under subdivision (1), (2), (3), (4), (5), (6) or (7) of subsection (b) of this section may be a member of the General Assembly.

(d) All appointments to the working group shall be made not later than thirty days after the effective date of this section. Any vacancy shall be filled by the appointing authority.

(e) The speaker of the House of Representatives and the president pro tempore of the Senate shall select the chairperson of the working group from among the members of the working group. Such chairperson shall schedule the first meeting of the working group, which shall be held not later than sixty days after the effective date of this section.

(f) Not later than January 1, 2017, the working group shall submit a report on its findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health, in accordance with the provisions of section 11-4a of the general statutes. The working group shall terminate on the date that it submits such report or January 1, 2017, whichever is later.

Sec. 513. (Effective from passage) The Commissioner of Social Services, in consultation with the Secretary of the Office of Policy and Management, may waive recoupment of an audit finding of overpayment made under the Medicaid program to a hospital that was under prior ownership during a portion of the audit period.

Sec. 514. (Effective from passage) (a) There is established a task force to study the furnishing of medical records by health care providers and health care institutions. Such study shall include, but need not be limited to, an examination of (1) the time frame for a heath care provider or health care institution to respond to a request for medical records, (2) the cost for research and copies in response to a request for medical records, and (3) the requirements of 45 CFR 164. 524 concerning individuals' access to their protected health information.

(b) The task force shall consist of the following members:

(1) Two appointed by the speaker of the House of Representatives, one who shall be a representative of a business that provides health information management services and one who shall be a member of the joint standing committee having cognizance of matters relating to public health;

(2) Two appointed by the president pro tempore of the Senate, one who shall be a representative of the Connecticut Trial Lawyers Association and one who shall be a member of the joint standing committee having cognizance of matters relating to public health;

(3) One appointed by the majority leader of the House of Representatives;

(4) One appointed by the majority leader of the Senate, who shall be a patient advocate;

(5) Two appointed by the minority leader of the House of Representatives, one who shall be a representative of the Connecticut State Medical Society and one who shall be a member of the joint standing committee having cognizance of matters relating to public health; and

(6) Two appointed by the minority leader of the Senate, who shall be a representative of the Connecticut Hospital Association and one who shall be a member of the joint standing committee having cognizance of matters relating to public health.

(c) Any member of the task force appointed under subdivision (1), (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member of the General Assembly.

(d) All appointments to the task force shall be made not later than thirty days after the effective date of this section. Any vacancy shall be filled by the appointing authority.

(e) The speaker of the House of Representatives and the president pro tempore of the Senate shall select the chairperson of the task force from among the members of the task force. Such chairperson shall schedule the first meeting of the task force, which shall be held not later than sixty days after the effective date of this section.

(f) Not later than January 1, 2017, the task force shall submit a report on its findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health, in accordance with the provisions of section 11-4a of the general statutes. The task force shall terminate on the date that it submits such report or January 1, 2017, whichever is later.

Sec. 515. (NEW) (Effective from passage) (a) As used in this section and section 516 of this act, "Connecticut protection and advocacy system" means the nonprofit entity designated by the Governor in accordance with section 516 of this act to serve as the state's protection and advocacy system and client assistance program.

(b) The Connecticut protection and advocacy system shall provide the following:

(1) Protection and advocacy services for people with disabilities, as provided under the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 USC 15001, as amended from time to time; and

(2) A client assistance program, as provided under the Workforce Investment Act of 1998, 29 USC 732, as amended from time to time.

Sec. 516. (NEW) (Effective from passage) (a) Not later than October 1, 2016, the Office of Policy and Management shall issue a request for information from nonprofit entities concerning the ability of such entities to serve as the Connecticut protection and advocacy system to provide advocacy services, including, but not limited to, a client assistance program for people with disabilities, which system shall be in compliance with all federal laws setting forth protection and advocacy system requirements, including, but not limited to, 42 USC 15041 to 15045, inclusive, as amended from time to time, and all federal laws setting forth client assistance program requirements, including, but not limited to, 29 USC 732, as amended from time to time.

(b) Not later than November 1, 2016, the Office of Protection and Advocacy for Persons with Disabilities, established under section 46a-10 of the general statutes, in consultation with the Board of Protection and Advocacy for Persons with Disabilities, established under section 46a-9 of the general statutes, shall submit a plan to the Secretary of the Office of Policy and Management that (1) is consistent with state and federal law, (2) contains provisions for the effective transfer, not later than July 1, 2017, of the protection and advocacy and client assistance program functions of said office to a nonprofit entity, and (3) includes, but is not limited to, any proposed legislative changes.

(c) Notwithstanding the provisions of sections 4-212 to 4-219, inclusive, subdivision (21) of section 4e-1, and chapter 62a of the general statutes, not later than July 1, 2017, the Governor shall designate a nonprofit entity to serve as the Connecticut protection and advocacy system.

(d) Notwithstanding the provisions of section 4e-16 and chapter 62a of the general statutes, prior to its abolishment under section 517 of this act on July 1, 2017, the Office of Protection and Advocacy for Persons with Disabilities, with the approval of the Office of Policy and Management, may contract with one or more nonstate entities to perform any functions that said office is permitted or required to perform, except those relating to investigations conducted pursuant to sections 46a-11a to 46a-11f, inclusive, of the general statutes.

(e) Nothing in chapter 10 of the general statutes shall prohibit any member of the Board of Advocacy and Protection for Persons with Disabilities or any employee of the Office of Protection and Advocacy for Persons with Disabilities from serving on the board of the Connecticut protection and advocacy system or working as an employee of such system, provided no state employee is employed by such system while employed by the state.

Sec. 517. (NEW) (Effective July 1, 2017) The Office of Protection and Advocacy for Persons with Disabilities and the Board of Protection and Advocacy for Persons with Disabilities are abolished. Any work in progress at said office not completed on or before July 1, 2017, other than investigations initiated pursuant to sections 46a-11a to 46a-11f, inclusive, of the general statutes, shall be completed by the Connecticut protection and advocacy system, designated under section 519 of this act, in accordance with federal regulations and in the same manner and with the same effect as if completed by said office as it existed immediately prior to July 1, 2017.

Sec. 518. Section 17b-650a of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) There is created a Department of Rehabilitation Services. The Department of Social Services shall provide administrative support services to the Department of Rehabilitation Services until the Department of Rehabilitation Services requests cessation of such services, or until June 30, 2013, whichever is earlier. The Department of Rehabilitation Services shall be responsible for providing the following: (1) Services to the deaf and hearing impaired; (2) services for the blind and visually impaired; and (3) rehabilitation services in accordance with the provisions of the general statutes concerning the Department of Rehabilitation Services. The Department of Rehabilitation Services shall constitute a successor authority to the Bureau of Rehabilitative Services in accordance with the provisions of sections 4-38d, 4-38e and 4-39.

(b) The department head shall be the Commissioner of Rehabilitation Services, who shall be appointed by the Governor in accordance with the provisions of sections 4-5 to 4-8, inclusive, and shall have the powers and duties described in said sections. The Commissioner of Rehabilitation Services shall appoint such persons as may be necessary to administer the provisions of public act 11-44 and the Commissioner of Administrative Services shall fix the compensation of such persons in accordance with the provisions of section 4-40. The Commissioner of Rehabilitation Services may create such sections within the Department of Rehabilitation Services as will facilitate such administration, including a disability determinations section for which one hundred per cent federal funds may be accepted for the operation of such section in conformity with applicable state and federal regulations. The Commissioner of Rehabilitation Services may adopt regulations, in accordance with the provisions of chapter 54, to implement the purposes of the department as established by statute.

(c) The Commissioner of Rehabilitation Services shall, annually, in accordance with section 4-60, submit to the Governor a report in electronic format on the activities of the Department of Rehabilitation Services relating to services provided by the department to individuals who (1) are blind or visually impaired, (2) are deaf or hearing impaired, or (3) receive vocational rehabilitation services. The report shall include the data the department provides to the federal government that relates to the evaluation standards and performance indicators for the vocational rehabilitation services program. The commissioner shall submit the report in electronic format, in accordance with the provisions of section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies.

(d) Effective July 1, 2017, the Department of Rehabilitation Services shall constitute a successor department, in accordance with the provisions of sections 4-38d and 4-39, to the Office of Protection and Advocacy for Persons with Disabilities with respect to investigations of allegations of abuse or neglect pursuant to sections 46a-11a to 46a-11f, inclusive.

Sec. 519. (Effective from passage) (a) There is established, within available appropriations, within the Department of Public Health, a Diabetes Advisory Council. The advisory council shall (1) analyze the current state of diabetes prevention, control and treatment in the state; and (2) advise the department on methods to achieve the goal of the Centers for Disease Control in granting funds to the state for diabetes prevention.

(b) The advisory council shall consist of the following members, who shall be appointed by the Commissioner of Public Health not later than ninety days after the effective date of this section:

(1) Two representatives of the Department of Public Health;

(2) A member of the Connecticut Alliance of Diabetes Educators;

(3) A diabetes prevention advocate;

(4) One representative each from two locations of the Young Men's Christian Association in the state that provide a diabetes prevention program;

(5) A representative of an insurance carrier that covers residents of this state;

(6) One representative each from two federally qualified health centers;

(7) A representative of the Connecticut State Medical Society;

(8) A representative of an accountable care organization;

(9) A primary health care provider who is not employed by a hospital, federally qualified health center or accountable care organization;

(10) Two representatives of a research and bioscience manufacturer with expertise in metabolic diseases; and

(11) Any additional member the commissioner determines would be beneficial to serve as a member of the advisory council.

(b) The advisory council shall consist of the following additional members:

(1) The Commissioner of Social Services, or the commissioner's designee;

(2) The Comptroller, or the Comptroller's designee;

(3) The executive director of the Latino and Puerto Rican Affairs Commission, or the executive director's designee;

(4) The executive director of the African-American Affairs Commission, or the executive director's designee; and

(5) The cochairpersons of the joint standing committee of the General Assembly having cognizance of matters relating to public health, or such cochairpersons' designees, one of whom may be a legislator.

(c) Members shall receive no compensation except for reimbursement for necessary expenses incurred in performing their duties. The members shall elect the chairperson of the advisory council from among the members of the advisory council. A majority of the advisory council members shall constitute a quorum. Any action taken by the advisory council shall require a majority vote of those present.

(d) The advisory council shall (1) review the following: (A) Strategies to identify and enroll individuals at risk of diabetes in diabetes prevention programs; (B) strategies to identify and refer individuals with diabetes for enrollment in formal diabetes education classes and diabetes management programs; (C) the status of healthcare organizations reporting on clinical quality measures related to diabetes control; (D) existing state programs that address prevention, control, and treatment of diabetes; (E) evidence that supports the need for such programs; and (2) make recommendations to enhance and financially support such programs.

(e) The advisory council may (1) study the following: (A) The effectiveness of the existing state programs identified in subsection (d) of this section; (B) the financial impact of diabetes on the state, including, but not limited to, the prevalence of the disease and the cost to the state for, among other things, administering the programs identified in subsection (d) of this section; and (C) the coordination of such programs and other efforts among state agencies to prevent, control and treat diabetes; and (2) develop an action plan that sets forth steps for reducing the impact of diabetes on the state, including, but not limited to, expected outcomes for each step toward preventing, controlling and treating diabetes.

(f) Not later than January 1, 2017, the advisory council shall submit, in accordance with the provisions of section 11-4a of the general statutes, a progress report on its findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health. Not later than May 1, 2017, the advisory council shall submit, in accordance with the provisions of section 11-4a of the general statutes, a final report on its findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health. The advisory council shall terminate on the date that it submits such report or January 1, 2018, whichever is later.

Sec. 520. (Effective from passage) Notwithstanding the provisions of section 20-227 of the general statutes, the Department of Public Health shall not revoke or suspend the license of a funeral director or embalmer pursuant to subdivision (1) of section 20-227 of the general statutes prior to April 1, 2017, if the licensed funeral director or licensed embalmer completed an examination as part of a program in funeral directing and embalming at an institution of higher education that lost its accreditation within twenty-four months of the effective date of this section. "

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

Sec. 501

October 1, 2016

19a-492e(a) and (b)

Sec. 502

October 1, 2016

19a-495a(a) and (b)

Sec. 503

October 1, 2016

New section

Sec. 504

October 1, 2016

New section

Sec. 505

October 1, 2016

8-3e

Sec. 506

October 1, 2016

20-112a

Sec. 507

July 1, 2016

19a-244

Sec. 508

July 1, 2016

19a-200(a)

Sec. 509

October 1, 2016

19a-2a

Sec. 510

October 1, 2016

New section

Sec. 511

from passage

19a-6f

Sec. 512

from passage

New section

Sec. 513

from passage

New section

Sec. 514

from passage

New section

Sec. 515

from passage

New section

Sec. 516

from passage

New section

Sec. 517

July 1, 2017

New section

Sec. 518

from passage

17b-650a

Sec. 519

from passage

New section

Sec. 520

from passage

New section