Connecticut Seal

General Assembly

 

Raised Bill No. 5537

February Session, 2016

 

LCO No. 2459

 

*02459_______PH_*

Referred to Committee on PUBLIC HEALTH

 

Introduced by:

 

(PH)

 

AN ACT CONCERNING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES.

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

Section 1. Subparagraph (D) of subdivision (8) of section 19a-177 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(D) The commissioner shall collect the data required by subparagraph (A) of this subdivision, in the manner provided in said subparagraph, from each emergency medical service organization licensed or certified pursuant to chapter [386d] 368d. Any such emergency medical service organization that fails to comply with the provisions of this section shall be liable for a civil penalty not to exceed one hundred dollars per day for each failure to report the required data regarding emergency medical services provided to a patient, as determined by the commissioner. The civil penalties set forth in this subparagraph shall be assessed only after the department provides a written notice of deficiency and the organization is afforded the opportunity to respond to such notice. An organization shall have not more than fifteen business days after the date of receiving such notice to provide a written response to the department. The commissioner may adopt regulations, in accordance with chapter 54, concerning the development, implementation, monitoring and collection of emergency medical service system data. All state agencies licensed or certified as emergency medical service organizations shall be exempt from the civil penalties set forth in this subparagraph;

Sec. 2. Section 20-266p of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

On and after July 1, 2014, no person shall: (1) Buy, sell or fraudulently obtain or furnish any diploma, certificate, license, record or registration purporting to show that any person is qualified or authorized to practice tattooing, as provided in section 20-266o, or participate in buying, selling, fraudulently obtaining or furnishing any such document; (2) practice or attempt or offer to practice tattooing under cover of any diploma, certificate, license, record or registration illegally or fraudulently obtained or signed, or issued unlawfully or under fraudulent representation or mistake of fact in a material regard; (3) practice or attempt or offer to practice tattooing under a name other than such person's own name or under a false or assumed name; (4) aid or abet practice by a person not lawfully licensed to practice tattooing within this state or by a person whose license to practice has been suspended or revoked; (5) use in such person's advertising the word "tattoo", "tattooing" or any description of services involving marking or coloring, in an indelible manner, the skin of any person, without having obtained a license under the provisions of section 20-266o; [or] (6) practice tattooing on a person who is an unemancipated minor under eighteen years of age without the permission of such person's parent or guardian, or (7) engage in the practice of tattooing without having obtained a license under the provisions of section 20-266o. No person shall, during the time such person's license as a tattoo technician is revoked or suspended, practice or attempt or offer or advertise to practice tattooing or be employed by, work with or assist, in any way, any person licensed to practice tattooing. Any person who violates any provision of this section shall be guilty of a class D misdemeanor.

Sec. 3. Subdivision (1) of subsection (a) of section 19a-12e of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(1) "Health care professional" means any person licensed or who holds a permit pursuant to chapter 370, 372, 373, 375 to 378, inclusive, 379 to 381a, inclusive, 383 to 385, inclusive, 398 or 399;

Sec. 4. (NEW) (Effective October 1, 2016) A substance abuse treatment facility licensed as an institution pursuant to section 19a-490 of the general statutes, as amended by this act, and providing medication assisted treatment for opioid addiction shall be permitted to provide methadone delivery and related substance use treatment services to persons in a nursing home facility licensed pursuant to section 19a-493 of the general statutes. The Department of Public Health may allow the delivery of methadone and related substance use treatment services to a nursing home facility if the Commissioner of Public Health determines that such delivery would not endanger the health, safety or welfare of any patient. No such delivery shall be conducted unless a substance abuse treatment facility proposing the delivery of methadone and related substance use treatment services has made a request for such delivery in a form and manner prescribed by the commissioner and the commissioner has approved such request. Upon approving a request, the commissioner may impose conditions that assure the health, safety or welfare of the patients. The commissioner may revoke the approval of a request upon a finding that the health, safety or welfare of any patient has been jeopardized.

Sec. 5. Section 19a-490 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

As used in this chapter and sections 17b-261e, 38a-498b and 38a-525b:

(a) "Institution" means a hospital, short-term hospital special hospice, hospice inpatient facility, residential care home, health care facility for the handicapped, nursing home facility, [rest home,] home health care agency, homemaker-home health aide agency, [mental] behavioral health facility, assisted living services agency, substance abuse treatment facility, outpatient surgical facility, outpatient clinic, an infirmary operated by an educational institution for the care of students enrolled in, and faculty and employees of, such institution; a facility engaged in providing services for the prevention, diagnosis, treatment or care of human health conditions, including facilities operated and maintained by any state agency, except facilities for the care or treatment of mentally ill persons or persons with substance abuse problems; and a residential facility for persons with intellectual disability licensed pursuant to section 17a-227 and certified to participate in the Title XIX Medicaid program as an intermediate care facility for individuals with intellectual disability;

(b) "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;

(c) "Residential care home" [, "nursing home"] or "rest home" means [an establishment] a community residence that furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services that meet a need beyond the basic provisions of food, shelter and laundry and may qualify as a setting that allows residents to receive home and community-based services funded by state and federal programs;

(d) "Home health care agency" means a public or private organization, or a subdivision thereof, engaged in providing professional nursing services and the following services, available twenty-four hours per day, in the patient's home or a substantially equivalent environment: Homemaker-home health aide services as defined in this section, physical therapy, speech therapy, occupational therapy or medical social services. The agency shall provide professional nursing services and at least one additional service directly and all others directly or through contract. An agency shall be available to enroll new patients seven days a week, twenty-four hours per day;

(e) "Homemaker-home health aide agency" means a public or private organization, except a home health care agency, which provides in the patient's home or a substantially equivalent environment supportive services which may include, but are not limited to, assistance with personal hygiene, dressing, feeding and incidental household tasks essential to achieving adequate household and family management. Such supportive services shall be provided under the supervision of a registered nurse and, if such nurse determines appropriate, shall be provided by a social worker, physical therapist, speech therapist or occupational therapist. Such supervision may be provided directly or through contract;

(f) "Homemaker-home health aide services" as defined in this section shall not include services provided to assist individuals with activities of daily living when such individuals have a disease or condition that is chronic and stable as determined by a physician licensed in the state of Connecticut;

(g) ["Mental health facility"] "Behavioral health facility" means any facility [for the care or treatment of mentally ill or emotionally disturbed persons, or any mental health outpatient treatment facility that provides treatment to persons sixteen years of age or older who are receiving services from the Department of Mental Health and Addiction Services, but does not include family care homes for the mentally ill] that provides mental health services to persons eighteen years of age or older or substance use disorder services to persons of any age in an outpatient treatment or residential setting to ameliorate mental, emotional, behavioral or substance use disorder issues;

(h) "Alcohol or drug treatment facility" means any facility for the care or treatment of persons suffering from alcoholism or other drug addiction;

(i) "Person" means any individual, firm, partnership, corporation, limited liability company or association;

(j) "Commissioner" means the Commissioner of Public Health or the commissioner's designee;

(k) "Home health agency" means an agency licensed as a home health care agency or a homemaker-home health aide agency;

(l) "Assisted living services agency" means an agency that provides, among other things, nursing services and assistance with activities of daily living to a population that is chronic and stable;

(m) "Outpatient clinic" means an organization operated by a municipality or a corporation, other than a hospital, that provides (1) ambulatory medical care, including preventive and health promotion services, (2) dental care, or (3) mental health services in conjunction with medical or dental care for the purpose of diagnosing or treating a health condition that does not require the patient's overnight care; [and]

(n) "Multicare institution" means a hospital, psychiatric outpatient clinic for adults, free-standing facility for the care or treatment of substance abusive or dependent persons, hospital for psychiatric disabilities, as defined in section 17a-495, or a general acute care hospital that provides outpatient behavioral health services that (1) is licensed in accordance with this chapter, (2) has more than one facility or one or more satellite units owned and operated by a single licensee, and (3) offers complex patient health care services at each facility or satellite unit; [.] and

(o) "Nursing home" or "nursing home facility" means (1) any chronic and convalescent nursing home or any rest home with nursing supervision that provides nursing supervision under a medical director twenty-four hours per day, or (2) any chronic and convalescent nursing home that provides skilled nursing care under medical supervision and direction to carry out nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages, acute diseases or injuries.

Sec. 6. Section 19a-541 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

As used in this section and sections 19a-542 to 19a-549, inclusive, unless the context otherwise requires:

(1) "Nursing home facility" has the same meaning as provided in section [19a-521] 19a-490, as amended by this act;

(2) "Emergency" means a situation, physical condition or one or more practices, methods or operations that presents imminent danger of death or serious physical or mental harm to residents of a nursing home facility;

(3) "Transfer trauma" means the medical and psychological reactions to physical transfer that increase the risk of death or grave illness, or both, in elderly persons;

(4) "Substantial violation" means a violation of law that presents a reasonable likelihood of serious physical or mental harm to residents of a nursing home facility or residential care home; and

(5) "Residential care home" has the same meaning as provided in section [19a-521] 19a-490, as amended by this act.

Sec. 7. Section 19a-521 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

As used in this section and sections 19a-522 to 19a-534a, inclusive, 19a-536 to 19a-539, inclusive, 19a-550 to 19a-554, inclusive, and 19a-562a, unless the context otherwise requires:

(1) "Nursing home facility" [means any nursing home or any rest home with nursing supervision that provides nursing supervision under a medical director twenty-four hours per day, or any chronic and convalescent nursing home that provides skilled nursing care under medical supervision and direction to carry out nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages, acute diseases or injuries] has the same meaning as provided in section 19a-490, as amended by this act;

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

(3) "Commissioner" means the Commissioner of Public Health or the commissioner's designated representative; and

(4) "Residential care home" [means an establishment that furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services that meet a need beyond the basic provisions of food, shelter and laundry] has the same meaning as provided in section 19a-490, as amended by this act.

Sec. 8. Section 67 of special act 14-5, as amended by section 67 of public act 14-231, is amended to read as follows (Effective from passage):

(h) Any pilot program established in accordance with this section shall terminate not later than [October 1, 2016] October 2, 2017.

Sec. 9. Section 20-123b of the 2016 supplement to the general statutes is amended by adding subsection (e) as follows (Effective October 1, 2016):

(NEW) (e) The commissioner may deny or revoke a permit based on disciplinary action taken against a dentist pursuant to the provisions of section 20-114, as amended by this act.

Sec. 10. Subsection (b) of section 20-126c of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(b) Except as otherwise provided in this section, a licensee applying for license renewal shall earn a minimum of twenty-five 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; (2) reflect the professional needs of the licensee in order to meet the health care needs of the public; and (3) include not less than one contact hour of training or education in (A) any [four] three of the ten mandatory topics for continuing education activities prescribed by the commissioner pursuant to this subdivision, [and] (B) infection control in a dental setting, and (C) prescribing controlled substances and pain management. For registration periods beginning on and after October 1, 2011, the Commissioner of Public Health, in consultation with the Dental Commission, shall on or before October 1, 2010, and biennially thereafter, issue a list that includes ten mandatory topics for continuing education activities that will be required for the following two-year registration period. Qualifying continuing education activities include, but are not limited to, courses, including on-line courses, offered or approved by the American Dental Association or state, district or local dental associations and societies affiliated with the American Dental Association; national, state, district or local dental specialty organizations or the American Academy of General Dentistry; a hospital or other health care institution; dental schools and other schools of higher education accredited or recognized by the Council on Dental Accreditation or a regional accrediting organization; agencies or businesses whose programs are accredited or recognized by the Council on Dental Accreditation; local, state or national medical associations; a state or local health department; or the Accreditation Council for Graduate Medical Education. Eight hours of volunteer dental practice at a public health facility, as defined in section 20-126l, as amended by this act, may be substituted for one contact hour of continuing education, up to a maximum of ten contact hours in one twenty-four-month period.

Sec. 11. Subsection (g) of section 20-126l of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(g) Each licensed dental hygienist applying for license renewal shall earn a minimum of sixteen hours of continuing education within the preceding twenty-four-month period, including, but not limited to, at least one hour of training or education in infection control in a dental setting. The subject matter for continuing education shall reflect the professional needs of the licensee in order to meet the health care needs of the public. Continuing education activities shall provide significant theoretical or practical content directly related to clinical or scientific aspects of dental hygiene. Qualifying continuing education activities include, but are not limited to, courses, including on-line courses, that are offered or approved by dental schools and other institutions of higher education that are accredited or recognized by the Council on Dental Accreditation, a regional accrediting organization, the American Dental Association, a state, district or local dental association or society affiliated with the American Dental Association, the National Dental Association, the American Dental Hygienists Association or a state, district or local dental hygiene association or society affiliated with the American Dental Hygienists Association, the Academy of General Dentistry, the Academy of Dental Hygiene, the American Red Cross or the American Heart Association when sponsoring programs in cardiopulmonary resuscitation or cardiac life support, the United States Department of Veterans Affairs and armed forces of the United States when conducting programs at United States governmental facilities, a hospital or other health care institution, agencies or businesses whose programs are accredited or recognized by the Council on Dental Accreditation, local, state or national medical associations, or a state or local health department. Eight hours of volunteer dental practice at a public health facility, as defined in subsection (a) of this section, may be substituted for one hour of continuing education, up to a maximum of five hours in one two-year period. Activities that do not qualify toward meeting these requirements include professional organizational business meetings, speeches delivered at luncheons or banquets, and the reading of books, articles, or professional journals. Not more than four hours of continuing education may be earned through an on-line or other distance learning program.

Sec. 12. Subsection (a) of section 20-114 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) The Dental Commission may take any of the actions set forth in section 19a-17 for any of the following causes: (1) The presentation to the department of any diploma, license or certificate illegally or fraudulently obtained, or obtained from an institution that is not reputable or from an unrecognized or irregular institution or state board, or obtained by the practice of any fraud or deception; (2) proof that a practitioner has become unfit or incompetent or has been guilty of cruelty, incompetence, negligence or indecent conduct toward patients; (3) conviction of the violation of any of the provisions of this chapter by any court of criminal jurisdiction, provided no action shall be taken under section 19a-17 because of such conviction if any appeal to a higher court has been filed until the appeal has been determined by the higher court and the conviction sustained; (4) the employment of any unlicensed person for other than mechanical purposes in the practice of dental medicine or dental surgery subject to the provisions of section 20-122a; (5) the violation of any of the provisions of this chapter or of the regulations adopted hereunder or the refusal to comply with any of said provisions or regulations; (6) the aiding or abetting in the practice of dentistry, dental medicine or dental hygiene of a person not licensed to practice dentistry, dental medicine or dental hygiene in this state; (7) designating a limited practice, except as provided in section 20-106a; (8) engaging in fraud or material deception in the course of professional activities; (9) the effects of physical or mental illness, emotional disorder or loss of motor skill, including, but not limited to, deterioration through the aging process, upon the license holder; (10) abuse or excessive use of drugs, including alcohol, narcotics or chemicals; (11) failure to comply with the continuing education requirements set forth in section 20-126c, as amended by this act; (12) failure of a holder of a permit authorizing the use of moderate sedation, deep sedation or general anesthesia to successfully complete an on-site evaluation conducted pursuant to subsection (c) of section 20-123b, as amended by this act; (13) failure to provide information to the Department of Public Health required to complete a health care provider profile, as set forth in section 20-13j; [or] (14) failure to maintain professional liability insurance or other indemnity against liability for professional malpractice as provided in section 20-126d; or (15) failure to adhere to the most recent version of the National Centers for Disease Control and Prevention's guidelines for infection control in dental care settings. A violation of any of the provisions of this chapter by any unlicensed employee in the practice of dentistry or dental hygiene, with the knowledge of the employer, shall be deemed a violation by the employer. The Commissioner of Public Health may order a license holder to submit to a reasonable physical or mental examination if his or her 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. 13. Section 20-112a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) A licensed dentist may delegate to dental assistants such dental procedures as the dentist may deem advisable, including the taking of dental x-rays if the dental assistant can demonstrate successful completion of the dental radiography portion of an examination prescribed by the Dental Assisting National Board, but such procedures shall be performed under the dentist's supervision and control and the dentist shall assume responsibility for such procedures; provided such assistants may not 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 impression of the teeth or jaws or the relationship of the teeth or jaws for the purpose of fabricating any appliance or prosthesis; (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, as amended by this act.

(b) On and after January 1, 2018, no licensed dentist may delegate dental procedures to a dental assistant unless the dental assistant provides records demonstrating successful completion of the Dental Assisting National Board's infection control examination. 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.

Sec. 14. Subsection (c) of section 20-195q of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(c) Nothing in this section shall prohibit: (1) A student enrolled in a doctoral or master's degree program accredited by the Council on Social Work Education from performing such work as is incidental to his course of study, provided such person is designated by a title which clearly indicates his status as a student; (2) [a person holding a doctoral or master's degree from a program accredited by the Council on Social Work Education from gaining social work experience under professional supervision, provided such activities are necessary to satisfy the work experience required by section 20-195n and such person is designated as "social work intern", "social work trainee" or other title clearly indicating the status appropriate to his level of training; (3)] a person licensed or certified in this state in a field other than clinical social work from practicing within the scope of such license or certification; [(4)] (3) a person enrolled in an educational program or fulfilling other state requirements leading to licensure or certification in a field other than social work from engaging in work in such other field; [(5)] (4) a person who is employed or retained as a social work designee, social worker, or social work consultant by a nursing home or rest home licensed under section 19a-490, as amended by this act, and who meets the qualifications prescribed by the department in its regulations from performing the duties required of them in accordance with state and federal laws governing those duties; [(6)] (5) for the period from October 1, 2010, to October 1, 2013, inclusive, a master social worker from engaging in independent practice; [(7)] (6) a social worker from practicing community organization, policy and planning, research or administration that does not include engaging in clinical social work or supervising a social worker engaged in clinical treatment with clients; and [(8)] (7) individuals with a baccalaureate degree in social work from a Council on Social Work Education accredited program from performing nonclinical social work functions.

Sec. 15. Subdivision (4) of subsection (c) of section 19a-88 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(4) Each person holding a license as a nurse-midwife shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of one hundred thirty dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the person maintains current certification from the [American College of Nurse-Midwives] Accreditation Midwifery Certification Board.

Sec. 16. Subdivision (2) of section 20-86a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(2) "Nurse-midwife" means a person who has demonstrated competence to practice nurse-midwifery through successful completion of an educational program accredited by the [American College of Nurse-Midwives] Accreditation Commission for Midwifery Education and who is certified by the [American College of Nurse-Midwives] American Midwifery Certification Board, and is licensed under the provisions of this chapter.

Sec. 17. Section 20-86b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

Nurse-midwives shall practice within a health care system and have clinical relationships with obstetrician-gynecologists that provide for consultation, collaborative management or referral, as indicated by the health status of the patient. Nurse-midwifery care shall be consistent with the standards of care established by the [American College of Nurse-Midwives] Accreditation Commission for Midwifery Education. Each nurse-midwife shall provide each patient with information regarding, or referral to, other providers and services upon request of the patient or when the care required by the patient is not within the midwife's scope of practice. Each nurse-midwife shall sign the birth certificate of each infant delivered by the nurse-midwife. If an infant is born alive and then dies within the twenty-four-hour period after birth, the nurse-midwife may make the actual determination and pronouncement of death provided: (1) The death is an anticipated death; (2) the nurse-midwife attests to such pronouncement on the certificate of death; and (3) the nurse-midwife or a physician licensed pursuant to chapter 370 certifies the certificate of death not later than twenty-four hours after such pronouncement. In a case of fetal death, as described in section 7-60, the nurse-midwife who delivered the fetus may make the actual determination of fetal death and certify the date of delivery and that the fetus was born dead.

Sec. 18. Section 20-86c of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

The Department of Public Health may issue a license to practice nurse-midwifery upon receipt of a fee of one hundred dollars, to an applicant who (1) is eligible for registered nurse licensure in this state, under sections 20-93 or 20-94; (2) holds and maintains current certification from the [American College of Nurse-Midwives] American Midwifery Certification Board; and (3) has completed thirty hours of education in pharmacology for nurse-midwifery. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

Sec. 19. Section 20-86i of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

Nothing in this chapter shall be construed to prohibit graduates of nurse-midwifery programs approved by the [American College of Nurse-Midwives] Accreditation Commission for Midwifery Education from practicing midwifery for a period not to exceed (1) ninety calendar days after the date of graduation, or (2) the date upon which the graduate is notified that he or she has failed the licensure examination, whichever is shorter, provided (A) such graduate nurses are working in a hospital or organization where adequate supervision, as determined by the Commissioner of Public Health, is provided, and (B) such hospital or other organization has verified that the graduate nurse has successfully completed a midwifery program approved by the [American College of Nurse-Midwives] Accreditation Commission for Midwifery Education.

Sec. 20. Section 20-254 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) Any person who holds a license at the time of application as a registered hairdresser and cosmetician, or as a person entitled to perform similar services under different designations in any other state, in the District of Columbia, or in a commonwealth or territory of the United States, and who was issued such license on the basis of successful completion of a program of education and training in hairdressing and cosmetology and an examination shall be eligible for licensing in this state and entitled to a license without examination upon payment of a fee of [fifty] one hundred dollars. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.

(b) If the issuance of such license in any other state, in the District of Columbia, or in a commonwealth or territory of the United States did not require an examination, an applicant who has legally practiced cosmetology for at least five years in a state outside of Connecticut shall be eligible for licensure under this section if the applicant submits to the commissioner evidence of education and experience that is satisfactory to the commissioner and upon payment of a fee of [fifty] one hundred dollars. Evidence of experience shall include, but not be limited to, (1) an original certification from the out-of-state licensing agency demonstrating at least five years of licensure, (2) correspondence from the applicant's former employers, coworkers or clients that describes the applicant's experience in the state for at least five years, and (3) a copy of tax returns that indicate cosmetology as the applicant's occupation. No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint in the context of providing services as a cosmetician.

Sec. 21. Section 19a-37 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) The Commissioner of Public Health may adopt regulations in the Public Health Code for the preservation of the public health pertaining to (1) protection and location of new water supply wells or springs for residential construction or for public or semipublic use, and (2) inspection for compliance with the provisions of municipal regulations adopted pursuant to section 22a-354p.

(b) The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, for the testing of water quality in private residential wells and wells for semipublic use. Any laboratory or firm which conducts a water quality test on a private well serving a residential property or well for semipublic use shall, not later than thirty days after the completion of such test, report the results of such test to (1) the public health authority of the municipality where the property is located, and (2) the Department of Public Health in a format specified by the department, provided such report shall not be required if the party for whom the laboratory or firm conducted such test informs the laboratory or firm that the test was not conducted within six months of the sale of such property. No regulation may require such a test to be conducted as a consequence or a condition of the sale, exchange, transfer, purchase or rental of the real property on which the private residential well or well for semipublic use is located. For purposes of this section, "laboratory or firm" means an environmental laboratory registered by the Department of Public Health pursuant to section 19a-29a.

(c) Prior to the sale, exchange, purchase, transfer or rental of real property on which a residential well is located, the owner shall provide the buyer or tenant notice that educational material concerning private well testing is available on the Department of Public Health web site. Failure to provide such notice shall not invalidate any sale, exchange, purchase, transfer or rental of real property. If the seller or landlord provides such notice in writing, the seller or landlord and any real estate licensee shall be deemed to have fully satisfied any duty to notify the buyer or tenant that the subject real property is located in an area for which there are reasonable grounds for testing under subsection (f) or (i) of this section.

(d) The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, to clarify the criteria under which the commissioner may issue a well permit exception and to describe the terms and conditions that shall be imposed when a well is allowed at a premises (1) that is connected to a public water supply system, or (2) whose boundary is located within two hundred feet of an approved community water supply system, measured along a street, alley or easement. Such regulations shall (A) provide for notification of the permit to the public water supplier, (B) address the quality of the water supplied from the well, the means and extent to which the well shall not be interconnected with the public water supply, the need for a physical separation, and the installation of a reduced pressure device for backflow prevention, the inspection and testing requirements of any such reduced pressure device, and (C) identify the extent and frequency of water quality testing required for the well supply.

(e) No regulation may require that a certificate of occupancy for a dwelling unit on such residential property be withheld or revoked on the basis of a water quality test performed on a private residential well pursuant to this section, unless such test results indicate that any maximum contaminant level applicable to public water supply systems for any contaminant listed in the public health code has been exceeded. No administrative agency, health district or municipal health officer may withhold or cause to be withheld such a certificate of occupancy except as provided in this section.

(f) The local director of health may require a private residential well or well for semipublic use to be tested for arsenic, radium, uranium, radon or gross alpha emitters, when there are reasonable grounds to suspect that such contaminants are present in the groundwater. For purposes of this subsection, "reasonable grounds" means (1) the existence of a geological area known to have naturally occurring arsenic, radium, uranium, radon or gross alpha emitter deposits in the bedrock; or (2) the well is located in an area in which it is known that arsenic, radium, uranium, radon or gross alpha emitters are present in the groundwater.

(g) Except as provided in subsection (h) of this section, the collection of samples for determining the water quality of private residential wells and wells for semipublic use may be made only by (1) employees of a laboratory or firm certified or approved by the Department of Public Health to test drinking water, if such employees have been trained in sample collection techniques, (2) certified water operators, (3) local health departments and state employees trained in sample collection techniques, or (4) individuals with training and experience that the Department of Public Health deems sufficient.

(h) Any owner of a residential construction, including, but not limited to, a homeowner, on which a private residential well is located or any general contractor of a new residential construction on which a private residential well is located may collect samples of well water for submission to a laboratory or firm for the purposes of testing water quality pursuant to this section, provided (1) such laboratory or firm has provided instructions to said owner or general contractor on how to collect such samples, and (2) such owner or general contractor is identified to the subsequent owner on a form to be prescribed by the Department of Public Health. No regulation may prohibit or impede such collection or analysis.

(i) The local director of health may require private residential wells and wells for semipublic use to be tested for pesticides, herbicides or organic chemicals when there are reasonable grounds to suspect that any such contaminants might be present in the groundwater. For purposes of this subsection, "reasonable grounds" means (1) the presence of nitrate-nitrogen in the groundwater at a concentration greater than ten milligrams per liter, or (2) that the private residential well or well for semipublic use is located on land, or in proximity to land, associated with the past or present production, storage, use or disposal of organic chemicals as identified in any public record.

Sec. 22. Subdivision (1) of section 46b-20a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(1) Not a party to another marriage, or a relationship that provides substantially the same rights, benefits and responsibilities as a marriage, entered into in this state or another state or jurisdiction, unless the parties to the marriage will be the same as the parties to such other [marriage or] relationship;

Sec. 23. Section 19a-55 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(a) The administrative officer or other person in charge of each institution caring for newborn infants shall cause to have administered to every such infant in its care an HIV-related test, as defined in section 19a-581, a test for phenylketonuria and other metabolic diseases, hypothyroidism, galactosemia, sickle cell disease, maple syrup urine disease, homocystinuria, biotinidase deficiency, congenital adrenal hyperplasia, severe combined immunodeficiency disease, adrenoleukodystrophy and such other tests for inborn errors of metabolism as shall be prescribed by the Department of Public Health. The tests shall be administered as soon after birth as is medically appropriate. If the mother has had an HIV-related test pursuant to section 19a-90 or 19a-593, the person responsible for testing under this section may omit an HIV-related test. The Commissioner of Public Health shall (1) administer the newborn screening program, (2) direct persons identified through the screening program to appropriate specialty centers for treatments, consistent with any applicable confidentiality requirements, and (3) set the fees to be charged to institutions to cover all expenses of the comprehensive screening program including testing, tracking and treatment. The fees to be charged pursuant to subdivision (3) of this subsection shall be set at a minimum of ninety-eight dollars. The Commissioner of Public Health shall publish a list of all the abnormal conditions for which the department screens newborns under the newborn screening program, which shall include screening for amino acid disorders, organic acid disorders and fatty acid oxidation disorders, including, but not limited to, long-chain 3-hydroxyacyl CoA dehydrogenase (L-CHAD) and medium-chain acyl-CoA dehydrogenase (MCAD).

(b) In addition to the testing requirements prescribed in subsection (a) of this section, the administrative officer or other person in charge of each institution caring for newborn infants shall cause to have administered to (1) every such infant in its care a screening test for (A) cystic fibrosis, [(B) severe combined immunodeficiency disease, and (C)] and (B) critical congenital heart disease, and (2) any newborn infant who fails a newborn hearing screening, as described in section 19a-59, a screening test for cytomegalovirus, provided such screening test shall be administered within available appropriations on and after January 1, 2016. Such screening tests shall be administered as soon after birth as is medically appropriate.

[(c) On or before October 1, 2015, the Commissioner of Public Health shall execute an agreement with the New York State Department of Health to conduct a screening test of newborns for adrenoleukodystrophy using dried blood spots, as well as the development of a quality assurance testing methodology for such test. The commissioner may accept private grants and donations to defray the cost of purchasing equipment that is necessary to perform the testing described in this subsection.]

[(d)] (c) The administrative officer or other person in charge of each institution caring for newborn infants shall report any case of cytomegalovirus that is confirmed as a result of a screening test administered pursuant to subdivision (2) of subsection (b) of this section to the Department of Public Health in a form and manner prescribed by the Commissioner of Public Health.

[(e)] (d) The provisions of this section shall not apply to any infant whose parents object to the test or treatment as being in conflict with their religious tenets and practice. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to implement the provisions of this section.

Sec. 24. Subdivisions (1) and (2) of subsection (j) of section 19a-491 of the 2016 supplement to the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

(j) (1) A chronic disease hospital shall (A) maintain its medical records on-site in an accessible manner or be able to retrieve such records from an off-site location not later than twenty-four hours after receiving a request for such records, (B) keep a patient's medical records on-site for a minimum of ten years after the date of such patient's discharge, except the hospital may destroy the patient's original medical records prior to the expiration of the ten-year period if a copy of such medical records is preserved by a process that is consistent with current hospital standards, or (C) complete a patient's medical records not more than thirty days after the date of such patient's discharge, except in unusual circumstances that shall be specified in the hospital's rules and regulations for its medical staff. Each chronic disease hospital shall provide the Department of Public Health with a list of the process it uses for preserving a copy of medical records in accordance with subparagraph (B) of this subdivision.

(2) A children's hospital shall (A) maintain its medical records, except nurses' notes, on-site in an accessible manner or be able to retrieve such records from an off-site location not later than twenty-four hours after receiving a request for such records, and (B) keep a patient's medical records on-site for a minimum of ten years after the date of such patient's discharge, except the hospital may destroy the patient's original medical records prior to the expiration of the ten-year period if a copy of such medical records is preserved by a process that is consistent with current hospital standards. Each children's hospital shall provide the Department of Public Health a list of the process it uses for preserving a copy of medical records in accordance with subparagraph (B) of this subdivision.

Sec. 25. Section 19a-270 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

The first selectman of any town, the mayor of any city, the administrative head of any state correctional institution or the superintendent or person in charge of any almshouse, asylum, hospital, morgue or other public institution which is supported, in whole or in part, at public expense, having in his or her possession or control the dead body of any person which, if not claimed as provided in this section, would have to be buried at public expense, or at the expense of any such institution, shall, immediately upon the death of such person, notify such person's relatives thereof, if known, and, if such relatives are not known, shall notify the person or persons bringing or committing such person to such institution. [Such] An acute care hospital official shall, not later than seven days after the date on which such body came into his or her possession or control, and such other official shall, [within] not later than twenty-four hours [from] after the time such body came into his or her possession or control, give notice thereof to the Department of Public Health and shall deliver such body to The University of Connecticut, Quinnipiac University, the Yale University School of Medicine or the University of Bridgeport College of Chiropractic or its successor institution, as said department may direct and in accordance with an agreement to be made among said universities in such manner as is directed by said department and at the expense of the university receiving the body, if The University of Connecticut, Quinnipiac University, Yale University, or the University of Bridgeport College of Chiropractic or its successor institution, at any time within one year, has given notice to any of such officials that such bodies would be needed for the purposes specified in section 19a-270b; provided any such body shall not have been claimed by a relative, either by blood or marriage, or a legal representative of such deceased person prior to delivery to any of said universities. The university receiving such body shall not embalm such body for a period of at least forty-eight hours after death, and any relative, either by blood or marriage, or a legal representative of such deceased person may claim such body during said period. If any such body is not disposed of in either manner specified in this section, it may be cremated or buried. When any person has in his or her possession or control the dead body of any person which would have to be buried at public expense or at the expense of any such institution, he or she shall, within forty-eight hours after such body has come into his or her possession or control, file, with the registrar of the town within which such death occurred, a certificate of death as provided in section 7-62b, unless such certificate has been filed by a funeral director. Before any such body is removed to any of said universities, the official or person contemplating such removal shall secure a removal, transit and burial permit which shall be delivered with the body to the official in charge of such university, who shall make return of such removal, transit and burial permit in the manner provided in section 7-66.

Sec. 26. Section 20-206q of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):

A certified dietitian-nutritionist may write an order for a patient diet, including, but not limited to, a therapeutic diet for a patient in an institution, as defined in section 19a-490. The certified dietitian-nutritionist shall write such order in the patient's medical record. Any order conveyed under this section shall be acted upon by the institution's nurses and physician assistants with the same authority as if the order were received directly from a physician. [Any order conveyed in this manner shall be countersigned by a physician within seventy-two hours unless otherwise provided by state or federal law or regulations.] Nothing in this section shall prohibit a physician from conveying a verbal order for a patient diet to a certified dietitian-nutritionist, which verbal order shall be countersigned by a physician not later than seventy-two hours after being conveyed, unless otherwise provided by state or federal law.

Sec. 27. (NEW) (Effective October 1, 2016) (a) Except for the portion of a delivered placenta that is necessary for an examination described in subsection (d) of this section, a hospital may allow a woman who has given birth in the hospital, or a spouse of the woman if the woman is incapacitated or deceased, to take possession of and remove from the hospital the placenta if:

(1) The woman tests negative for infectious diseases; and

(2) The person taking possession of the placenta provides a written acknowledgment that (A) the person received from the hospital educational information concerning the spread of blood-borne diseases from placentas, the danger of ingesting formalin and the proper handling of placentas, and (B) the placenta is for personal use.

(b) A person removing a placenta from a hospital under this section may only retain the placenta for personal use and may not sell the placenta.

(c) The hospital shall retain the signed acknowledgment described in subsection (a) with the woman's medical records.

(d) This section does not (1) prohibit a pathological examination of the delivered placenta that is ordered by a physician or required by a policy of the hospital, or (2) authorize a woman or the woman's spouse to interfere with a pathological examination of the delivered placenta that is ordered by a physician or required by a policy of the hospital.

(f) A hospital that allows a person to take possession of and remove from the hospital a delivered placenta in accordance with the provisions of this section is not required to dispose of the placenta as biomedical waste.

(g) A hospital that acts in accordance with the provisions of this section shall not be liable for allowing the removal of a placenta from the hospital in a civil action, a criminal prosecution or an administrative proceeding.

Sec. 28. (NEW) (Effective October 1, 2016) (a) As used in this section, "psychology technician" means a person who (1) holds a bachelor's or graduate degree in psychology, and (2) has undergone not less than eighty hours of training by a psychologist licensed pursuant to chapter 383 of the general statutes, including, but not limited to, (A) education in professional ethics and best practices for the administration and scoring of objective psychological and neuropsychological tests, (B) direct observation of the administration and scoring of objective psychological and neuropsychological tests by the psychologist, and (C) not less than forty hours of administering and scoring objective psychological and neuropsychological tests in the presence of the psychologist.

(b) The services provided by psychology technicians include the administration and scoring of objective psychological or neuropsychological tests with specific, predetermined and manualized administrative procedures. The responsibilities of a psychology technician include, but are not limited to, observing and describing the behavior of the patient taking the test and the patient's test responses, but shall not include evaluation, interpretation or other judgments concerning the patient or the patient's test responses.

(c) A psychology technician may provide objective psychological or neuropsychological testing services under the supervision and direction of a psychologist licensed pursuant to chapter 383 of the general statutes, provided: (1) The psychologist is satisfied as to the ability and competency of the psychology technician; (2) services provided are consistent with the health and welfare of the patient and in keeping with the practice of psychology; and (3) such services are provided under the oversight, control and direction of the psychologist.

(d) Nothing in this section shall be construed to apply to the activities and services of a person who is enrolled in a psychology technician educational program acceptable to the American Psychological Association, provided such activities and services are incidental to the course of study.

(e) A psychology technician shall not: (1) Select tests; (2) conduct intake assessments; (3) conduct clinical interviews, including, but not limited to, patient interviews and collateral interviews of relatives, friends of the patient or other professionals associated with the patient; (4) interpret patient data; (5) communicate test results or treatment recommendations to patients; or (6) administer tests in educational institutions.

Sec. 29. Subsection (b) of section 20-10b of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(b) Except as otherwise provided in subsections (d), (e) and (f) of this section, 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) during the first renewal period in which continuing medical education is required and not less than once every six years thereafter, 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, including, but not limited to, for registration periods beginning on or after October 1, 2015, prescribing controlled substances and pain management, (C) sexual assault, (D) domestic violence, (E) cultural competency, and (F) behavioral health, provided further that on and after January 1, 2016, such behavioral health continuing medical education may include, but not be limited to, at least two contact hours of training or education during the first renewal period in which continuing education is required and not less than once every six years thereafter, on the topic of mental health conditions common to veterans and family members of veterans, including (i) determining whether a patient is a veteran or family member of a veteran, (ii) screening for conditions such as post-traumatic stress disorder, risk of suicide, depression and grief, and (iii) suicide prevention training. 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, Connecticut Osteopathic 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. The commissioner, or the commissioner's designee, may grant a waiver for not more than ten contact hours of continuing medical education for a physician who: (i) Engages in activities related to the physician's service as a member of the Connecticut Medical Examining Board, established pursuant to section 20-8a; (ii) engages in activities related to the physician's service as a member of a medical hearing panel, pursuant to section 20-8a; or (iii) assists the department with its duties to boards and commissions as described in section 19a-14.

Sec. 30. Sections 19a-56a, 19a-56b, 19a-57 and 20-86d of the general statutes are repealed. (Effective October 1, 2016)

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

Section 1

from passage

19a-177(8)(D)

Sec. 2

October 1, 2016

20-266p

Sec. 3

October 1, 2016

19a-12e(a)(1)

Sec. 4

October 1, 2016

New section

Sec. 5

October 1, 2016

19a-490

Sec. 6

October 1, 2016

19a-541

Sec. 7

October 1, 2016

19a-521

Sec. 8

from passage

SA 14-5, Sec. 67

Sec. 9

October 1, 2016

20-123b

Sec. 10

October 1, 2016

20-126c(b)

Sec. 11

October 1, 2016

20-126l(g)

Sec. 12

October 1, 2016

20-114(a)

Sec. 13

October 1, 2016

20-112a

Sec. 14

October 1, 2016

20-195q(c)

Sec. 15

October 1, 2016

19a-88(c)(4)

Sec. 16

October 1, 2016

20-86a(2)

Sec. 17

October 1, 2016

20-86b

Sec. 18

October 1, 2016

20-86c

Sec. 19

October 1, 2016

20-86i

Sec. 20

October 1, 2016

20-254

Sec. 21

October 1, 2016

19a-37

Sec. 22

October 1, 2016

46b-20a(1)

Sec. 23

October 1, 2016

19a-55

Sec. 24

October 1, 2016

19a-491(j)(1) and (2)

Sec. 25

October 1, 2016

19a-270

Sec. 26

October 1, 2016

20-206q

Sec. 27

October 1, 2016

New section

Sec. 28

October 1, 2016

New section

Sec. 29

from passage

20-10b(b)

Sec. 30

October 1, 2016

Repealer section

Statement of Purpose:

To make various revisions to the public health statutes.

[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.]