Public Health Committee

JOINT FAVORABLE REPORT

Bill No.:

HB-7222

Title:

AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES.

Vote Date:

3/27/2017

Vote Action:

Joint Favorable

PH Date:

3/20/2017

File No.:

SPONSORS OF BILL:

Public Health Committee

REASONS FOR BILL: This bill makes various revisions to the public health statutes.

RESPONSE FROM ADMINISTRATION/AGENCY:

Raul Pino, Commissioner Department of Public Health:

Sec. 1 Revises statutes pertaining to fees for facility licensure applications, ensuring that a facility has provided the appropriate documentation and licensure fee prior to the Department reviewing such documentation for accuracy and completeness.

Sec. 2 revises statutes pertaining to licensing of institutions, adding a definition of outpatient dialysis.

Sec. 3 adds definition of a contact hour for continuing education activity for a dental hygienist.

Sec. 4 adds cultural competency as a requirement for continuing education of dental hygienists.

Sec. 5 revises statutes changing asthma reporting requirements from an annual basis to a triennial basis.

Sec. 6 clarifies statute regarding issuance of a Do Not Resuscitate order.

Sec. 7 requires health care institution to provide the Department with immediate notification in the event of a major systems failure.

Sec. 8 would allow the Department to proceed with state disciplinary action on a practitioner's license based on federal agency enforcement action.

Sec. 9 after completing a secondary review the department ask that this section be removed.

Sec. 10 expands the definition of an occupational therapy assistant.

Sec. 11, 12, and 13 revises statutes dealing with psychology, professional counseling and martial and family therapy, prohibiting applicants for licensure from continuing to provide unlicensed services to clients after completing the statutorily required work experience.

Sec. 14 makes technical changes to statutes dealing with the purchase of special equipment for children and youth with special healthcare needs to ensure person first language.

Sec. 15 updates the Department's Birth Defects Registry to codify current practice and include person first language.

Sec. 16 allows critical congenital heart disease screening data to be reported to DPH through the same mechanism as the Departments Birth Defects Registry.

Sec. 17 clarifies the time periods for a lab or firm to submit results to the Department regarding samples collected from a private well or semipublic well use in conjunction with a real estate transaction.

Sec.18 makes technical corrections to the statues to clarify that all crematories must be 500 feet from residential structures or land regardless of local ordinances.

Sec.19 revises statues pertaining to the Quality of Care Advisory Committee to remove the requirement for this committee to meet on a semi-annual basis.

Sec. 20 revises statutes pertaining to the Public Health Preparedness Advisory Committee by updating the committee's mission, removing a requirement to meet regularly, and repealing a yearly reporting requirement.

Sec. 21 permits a long term care facility to continue to employ an applicant on a conditional supervised basis pending the determination of an applicant request for a waiver of a disqualifying offense.

Sec. 22 creates a $400 biennial registration fee for microbiological and biomedical biosafety labs and making technical changes that conform to current guidelines for different levels of microbiological and biomedical biosafety labs issued by the National Institutes of Health and the National Centers for Disease Control.

Sec. 23 repeals the statute that created the Women, Infants and Children Advisory Council.

Sec. 24 repeals statutes pertaining to interagency Partnership Advisory Panel on Lupus and the Advisory Council on Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections and Pediatric Acute Neuropsychiatric Syndrome.

Rep. Kim Rose: Requests that Physician Assistants be added in statute in the same manner as APRN's in all of the various statutes.

Rep. Ezequiel Santiago: Supports the inclusion of language in HB 7222 that would allow for the Advanced naturopathic care and permits a person licensed in the practice of naturopathy to engage in the practice of advanced naturopathic care. Adding this language will be a step in the right direction as it will allow graduates of the University of Bridgeport's program to set down roots in the local community contributing to the economic and professional vitality of the state.

NATURE AND SOURCES OF SUPPORT:

Cherie Poirier, Eastern Connecticut Area Health Education Center: Supports the passage of this bill especially Sec. 4. Cultural competency will help dental hygienist to respond to the increasing number of ethnic and racial minorities, decrease clinical errors, and eliminate long-standing disparities in the health status of people in the state.

Dr. Nicholas J. Palermo: Supports this legislation with inclusion of language allowing Naturopathic physician's to have limited prescriptive drug authority consistent with many other states.

Connecticut Hospital Association (CHA): Supports this legislation with some language changes. In sec. 7 CHA would like to work The Department of Public Health to clearly define the phrase “major system failures”.

Sec. 15 recommends that the language here be modified to allow for one member of the care team to issue the report or that limiting language be inserted that calls for the report, unless the provider is aware of the child already being included in the birth defect registry.

Ben Shaiken, The Alliance: Supports the legislation with language added specifying that Licensed Alcohol and Drug Counselors are permitted to provide treatment for behavioral health diagnoses as long as those behavioral health diagnoses are secondary to primary substance abuse problems.

Connecticut Advanced Practice Registered Nurse Society: Requests that updates to statutes be added pertaining to the practice of APRN's as listed in materials provided to the committee earlier in the legislative session.

Connecticut Academy of Physician Assistants (ConnAPA): This legislation references PAs in one area of the bill but excludes PA's elsewhere. The lack of clarity surrounds whether PAs will be authorized to provide specified services. For example, Sec. 6 speaks to which health providers may write Do Not Resuscitate orders and Sec. 15 speaks to those providers who may provide neonatal care services. PA's currently provide both of these services but currently HB 7222 names PAs only for neonatal care services. ConnAPA requests the appropriate inclusion of PAs in HB 7222 as well as other areas of Connecticut Statutes where other medical providers are named to provide that care.

Wheeler Clinic Inc: Urges the committee to intervene to protect effective addiction treatment in Connecticut by adding language specifying that Licensed Alcohol and Drug Counselors are permitted to provide treatment for behavioral health diagnoses as long as those behavioral health diagnoses are secondary to primary substance use or gambling problem disorders.

Dr. Shea Gregg, State Trauma Committee: Wants to improve the states trauma care system through improved data reporting and provide a voice for the state trauma committee by repealing Sec. 19a-178a Subsection (b) and (c) of the general statutes. These regulations have not been updated since 2005 and are grossly outdated.

William Young, InterCommunity: Urges the committee to intervene to protect effective addiction treatment in Connecticut by adding language specifying that Licensed Alcohol and Drug Counselors are permitted to provide treatment for behavioral health diagnoses as long as those behavioral health diagnoses are secondary to primary substance use or problem gambling disorder diagnoses.

Gregory B. Allard, Connecticut EMS Advisory Board: Requests the addition of language related to trauma care in the state of Connecticut. Section 19a-178a Subsection (b) and (c) of the general statutes is repealed and the following is substituted in lieu thereof:

(b) The advisory board shall consist of members appointed in accordance with the provisions of this subsection and shall include the Commissioner of Public Health and the department's emergency medical services medical director, or their designees, and each president of the five regional emergency medical service councils established pursuant to section 19a-183. The Governor shall appoint the following members: One person from the Connecticut Association of Directors of Health; three persons from the Connecticut College of Emergency Physicians; one person from the Connecticut Committee on Trauma of the American College of Surgeons; one person from the Connecticut Trauma Committee, one person from the Connecticut Medical Advisory Committee; one person from the Emergency Department Nurses Association; one person from the Connecticut Association of Emergency Medical Services Instructors; one person from the Connecticut Hospital Association; two persons representing commercial ambulance providers; one person from the Connecticut Firefighters Association; one person from the Connecticut Fire Chiefs Association; one person from the Connecticut Chiefs of Police Association; one person from the Connecticut State Police; and one person from the Connecticut Commission on Fire Prevention and Control. An additional eighteen members shall be appointed as follows: Three by the president pro tempore of the Senate; three by the majority leader of the Senate; four by the minority leader of the Senate; three by the speaker of the House of Representatives; two by the majority leader of the House of Representatives and three by the minority leader of the House of Representatives. The appointees shall include a person with experience in municipal ambulance services; a person with experience in for-profit ambulance services; three persons with experience in volunteer ambulance services; a paramedic; an emergency medical technician; an advanced emergency medical technician; three consumers and four persons from state-wide organizations with interests in emergency medical services as well as any other areas of expertise that may be deemed necessary for the proper functioning of the advisory board.

(c) The Commissioner of Public Health shall appoint a chairperson from among the members of the advisory board who shall serve for a term of one year. The advisory board shall elect a vice-chairperson and secretary. The advisory board shall have committees made up of such members as the chairperson shall appoint and such other interested persons as the committee members shall elect to membership. The advisory board may, from time to time, appoint nonmembers to serve on such ad hoc committees, as it deems necessary to assist with its functions. The advisory board shall develop bylaws. The advisory board shall establish a Connecticut Emergency Medical Services Medical Advisory Committee and a Connecticut Trauma Committee as [a] standing committees. The standing committees shall provide the commissioner, the advisory board and other ad hoc committees with advice and comment regarding the medical aspects of their projects. The commissioner shall, with the advice of the standing committees and the recommendation of the advisory board, adopt the contents of a data dictionary for the Connecticut trauma registry based on current national standards set forth by the National Trauma Data Bank and the American College of Surgeons Trauma Quality Improvement Program and Field Triage Protocols based upon current national standards. The standing committees may submit reports directly to the commissioner regarding medically related concerns that have not, in the standing committee's opinion, been satisfactorily addressed by the advisory board.

These changes will allow for the identifying of essential data about the most common trauma types and what patient population they are affecting. This data will be based on National Trauma Standards, which will keep Connecticut current. It will also allow the Trauma Committee to keep the Emergency Medical Service Providers current with Field Triage Protocols

The following individuals submitted testimony in favor of the legislation and request the inclusion of language allowing Naturopathic physician's limited prescriptive drug authority consistent with many other states. Currently, Connecticut is the only state without some form of prescriptive authority for Naturopathic Doctors:

Dr. Marcia Prenguber

Dr. Nina Molin

Anton Alder

NATURE AND SOURCES OF OPPOSITION: NONE

Reported by: Walter L. Morton IV

Date: 4/5/2017