Chapter 368a

(2) “Hepatitis C diagnostic test” means a laboratory test that detects the presence of hepatitis C virus in the blood and provides confirmation of whether the person whose blood is being tested has a hepatitis C virus infection;

(3) “HIV infection” means infection with the human immunodeficiency virus or any other related virus identified as a probable causative agent of acquired immune deficiency syndrome, as defined by the Centers for Disease Control and Prevention of the United States Public Health Service;

(4) “HIV–related test” means any laboratory test or series of tests for any virus, antibody, antigen or etiologic agent whatsoever thought to cause or indicate the presence of HIV infection;

(5) “Primary care provider” means a physician, advanced practice registered nurse or physician assistant who provides primary care services and is licensed by the Department of Public Health pursuant to title 20; and

(6) “Primary care” means the medical fields of family medicine, general pediatrics, primary care, internal medicine, primary care obstetrics or primary care gynecology, without regard to board certification.

(b) A primary care provider shall offer to provide to, or order for, each patient eighteen years of age and older, and each pregnant woman a hepatitis C screening test or hepatitis C diagnostic test at the time the primary care provider provides services to such patient, except a primary care provider is not required to offer to provide to, or order for, such patient a hepatitis C screening test or hepatitis C diagnostic test when the primary care provider reasonably believes: (1) Such patient is being treated for a life-threatening emergency; (2) such patient has previously been offered or has received a hepatitis C screening test; or (3) such patient lacks the capacity to consent to a hepatitis C screening test.

(c) On and after January 1, 2023, a primary care provider, or such provider's designee, shall offer to provide to, order for, or arrange for the order for, each patient who is thirteen years of age or older, an HIV-related test, except a primary care provider, or such provider's designee, is not required to offer to provide to, or order for, such patient an HIV-related test when the primary care provider reasonably believes: (1) Such patient is being treated for a life-threatening emergency; (2) such patient has previously been offered or has received an HIV-related test; or (3) such patient lacks the capacity to consent to an HIV-related test. The primary care provider, or such provider's designee, shall comply with all requirements concerning HIV-related testing and HIV-related information prescribed in chapter 368x.

(P.A. 14-203, S. 1; P.A. 22-58, S. 68; P.A. 23-31, S. 11; 23-195, S. 9.)

History: P.A. 22-58 amended Subsec. (a) by adding new Subdivs. (3) and (4) defining “HIV infection” and “HIV-related test”, redesignated existing Subdivs. (3) and (4) as Subdivs. (5) and (6), amended Subsec. (b) by deleting “On and after October 1, 2014, a” and making a technical change and added Subsec. (c) re provision of HIV-related tests to patients 13 years of age or older; P.A. 23-31 amended Subsec. (b) by replacing “who was born between 1945 to 1965, inclusive,” with “eighteen years of age and older, and each pregnant woman”; P.A. 23-195 amended Subsec. (a)(3) by making a technical change.

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(1) “Assistance program” means the program established pursuant to subsection (b) of this section to provide education, prevention, intervention, referral assistance, rehabilitation or support services to health care professionals, pharmacists and pharmacy interns who have a chemical dependency, emotional or behavioral disorder or physical or mental illness;

(2) “Chemical dependency” means abusive or excessive use of drugs, including alcohol, narcotics or chemicals, that results in physical or psychological dependence;

(3) “Health care professionals” includes any person licensed or who holds a permit pursuant to chapter 370, 372, 373, 375, 375a, 376, 376a, 376b, 376c, 377, 378, 379, 379a, 380, 381, 381a, 382a, 383, 383a, 383b, 383c, 384, 384a, 384b, 384c, 384d, 385, 398 or 399;

(4) “Medical review committee” means any committee that reviews and monitors participation by health care professionals, pharmacists or pharmacy interns in the assistance program, including a medical review committee described in section 19a-17b;

(5) “Pharmacist” has the same meaning as provided in section 20-571; and

(6) “Pharmacy intern” has the same meaning as provided in section 20-571.

(b) State or local professional societies or membership organizations of health care professionals, pharmacists and pharmacy interns, or any combination thereof, may establish a single assistance program to serve all health care professionals, pharmacists and pharmacy interns, provided the assistance program (1) operates in compliance with the provisions of this section and sections 20-638 to 20-638b, inclusive, and (2) includes one or more medical review committees that comply with the applicable provisions of (A) subsections (c) to (f), inclusive, of this section, and (B) subsections (b) to (h), inclusive, of section 20-638a. The program shall (i) be an alternative, voluntary and confidential opportunity for the rehabilitation of health care professionals, persons who have applied to become health care professionals, pharmacists and pharmacy interns, and (ii) include mandatory, periodic evaluations of each participant's ability to practice with skill and safety and without posing a threat to the health and safety of any person or patient in the health care or pharmacy setting.

(c) Prior to admitting a health care professional into the assistance program, a medical review committee shall (1) determine if the health care professional is an appropriate candidate for rehabilitation and participation in the program, and (2) establish the participant's terms and conditions for participating in the program. No action taken by the medical review committee pursuant to this subsection shall be construed as the practice of medicine or mental health care.

(d) A medical review committee shall not admit into the assistance program any health care professional who has pending disciplinary charges, prior history of disciplinary action or a consent order by any professional licensing or disciplinary body or has been charged with or convicted of a felony under the laws of this state, or of an offense that, if committed within this state, would constitute a felony. A medical review committee shall refer such health care professional to the Department of Public Health and shall submit to the department all records and files maintained by the assistance program concerning such health care professional. Upon such referral, the Department of Public Health shall determine if the health care professional is eligible to participate in the assistance program and whether such participation should be treated as confidential pursuant to subsection (h) of this section. The Department of Public Health may seek the advice of professional health care societies or organizations and the assistance program in determining what intervention, referral assistance, rehabilitation or support services are appropriate for such health care professional. If the Department of Public Health determines that the health care professional is an appropriate candidate for confidential participation in the assistance program, the entire record of the referral and investigation of the health care professional shall be confidential and shall not be disclosed, except at the request of the health care professional, for the duration of the health care professional's participation in and upon successful completion of the program, provided such participation is in accordance with terms agreed upon by the department, the health care professional and the assistance program.

(e) Any health care professional participating in the assistance program shall immediately notify the assistance program upon (1) being made aware of the filing of any disciplinary charges or the taking of any disciplinary action against such health care professional by a professional licensing or disciplinary body, or (2) being charged with or convicted of a felony under the laws of this state, or of an offense that, if committed within this state, would constitute a felony. The assistance program shall regularly review available sources to determine if disciplinary charges have been filed, or disciplinary action has been taken, or felony charges have been filed or substantiated against any health care professional who has been admitted to the assistance program. Upon such notification, the assistance program shall refer such health care professional to the Department of Public Health and shall submit to the department all records and files maintained by the assistance program concerning such health care professional. Upon such referral, the Department of Public Health shall determine if the health care professional is eligible to continue participating in the assistance program and whether such participation should be treated as confidential in accordance with subsection (h) of this section. The Department of Public Health may seek the advice of professional health care societies or organizations and the assistance program in determining what intervention, referral assistance, rehabilitation or support services are appropriate for such health care professional. If the Department of Public Health determines that the health care professional is an appropriate candidate for confidential participation in the assistance program, the entire record of the referral and investigation of the health care professional shall be confidential and shall not be disclosed, except at the request of the health care professional, for the duration of the health care professional's participation in and upon successful completion of the program, provided such participation is in accordance with terms agreed upon by the department, the health care professional and the assistance program.

(f) A medical review committee shall not admit into the assistance program any health care professional who is alleged to have harmed a patient. Upon being made aware of such allegation of harm a medical review committee and the assistance program shall refer such health care professional to the Department of Public Health and shall submit to the department all records and files maintained by the assistance program concerning such health care professional. Such referral may include recommendations as to what intervention, referral assistance, rehabilitation or support services are appropriate for such health care professional. Upon such referral, the Department of Public Health shall determine if the health care professional is eligible to participate in the assistance program and whether such participation should be provided in a confidential manner in accordance with the provisions of subsection (h) of this section. The Department of Public Health may seek the advice of professional health care societies or organizations and the assistance program in determining what intervention, referral assistance, rehabilitation or support services are appropriate for such health care professional. If the Department of Public Health determines that the health care professional is an appropriate candidate for confidential participation in the assistance program, the entire record of the referral and investigation of the health care professional shall be confidential and shall not be disclosed, except at the request of the health care professional, for the duration of the health care professional's participation in and upon successful completion of the program, provided such participation is in accordance with terms agreed upon by the department, the health care professional and the assistance program.

(g) The assistance program shall report annually to the appropriate professional licensing board or commission or, in the absence of such board or commission, to the Department of Public Health on the number of health care professionals participating in the assistance program who are under the jurisdiction of such board or commission or in the absence of such board or commission, the Department of Public Health, the purposes for participating in the assistance program and whether participants are practicing health care with skill and safety and without posing a threat to the health and safety of any person or patient in the health care setting. Annually, on or before December thirty-first, the assistance program shall report such information 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.

(h) (1) All information given or received in connection with any intervention, rehabilitation, referral assistance or support services provided by the assistance program pursuant to this section, including the identity of any health care professional seeking or receiving such intervention, rehabilitation, referral assistance or support services shall be confidential and shall not be disclosed (A) to any third person or entity, unless disclosure is reasonably necessary for the accomplishment of the purposes of such intervention, rehabilitation, referral assistance or support services or for the accomplishment of an audit in accordance with subsection (l) of this section, or (B) in any civil or criminal case or proceeding or in any legal or administrative proceeding, unless the health care professional seeking or obtaining intervention, rehabilitation, referral assistance or support services waives the confidentiality privilege under this subsection or unless disclosure is otherwise required by law. Unless a health care professional waives the confidentiality privilege under this subsection or disclosure is otherwise required by law, no person in any civil or criminal case or proceeding or in any legal or administrative proceeding may request or require any information given or received in connection with the intervention, rehabilitation, referral assistance or support services provided pursuant to this section.

(2) The proceedings of a medical review committee shall not be subject to discovery or introduced into evidence in any civil action for or against a health care professional arising out of matters that are subject to evaluation and review by such committee, and no person who was in attendance at such proceedings shall be permitted or required to testify in any such civil action as to the content of such proceedings. Nothing in this subdivision shall be construed to preclude (A) in any civil action, the use of any writing recorded independently of such proceedings; (B) in any civil action, the testimony of any person concerning such person's knowledge, acquired independently of such proceedings, about the facts that form the basis for the instituting of such civil action; (C) in any civil action arising out of allegations of patient harm caused by health care services rendered by a health care professional who, at the time such services were rendered, had been requested to refrain from practicing or whose practice of medicine or health care was restricted, the disclosure of such request to refrain from practicing or such restriction; or (D) in any civil action against a health care professional, disclosure of the fact that a health care professional participated in the assistance program, the dates of participation, the reason for participation and confirmation of successful completion of the program, provided a court of competent jurisdiction has determined that good cause exists for such disclosure after (i) notification to the health care professional of the request for such disclosure, and (ii) a hearing concerning such disclosure at the request of any party, and provided further, the court imposes appropriate safeguards against unauthorized disclosure or publication of such information.

(3) Nothing in this subsection shall be construed to prevent the assistance program from disclosing information in connection with administrative proceedings related to the imposition of disciplinary action against any health care professional referred to the Department of Public Health by the assistance program pursuant to subsection (d), (e), (f) or (i) of this section or by the Professional Assistance Oversight Committee pursuant to subsection (e) of section 19a-12b.

(i) If at any time, (1) the assistance program determines that a health care professional is not able to practice with skill and safety or poses a threat to the health and safety of any person or patient in the health care setting and the health care professional does not refrain from practicing health care or fails to participate in a recommended program of rehabilitation, or (2) a health care professional who has been referred to the assistance program fails to comply with terms or conditions of the program or refuses to participate in the program, the assistance program shall refer the health care professional to the Department of Public Health and shall submit to the department all records and files maintained by the assistance program concerning such health care professional. Upon such referral, the Department of Public Health shall determine if the health care professional is eligible to participate in the assistance program and whether such participation should be provided in a confidential manner in accordance with the provisions of subsection (h) of this section. The Department of Public Health may seek the advice of professional health care societies or organizations and the assistance program in determining what intervention, rehabilitation, referral assistance or support services are appropriate for such health care professional. If the Department of Public Health determines that the health care professional is an appropriate candidate for confidential participation in the assistance program, the entire record of the referral and investigation of the health care professional shall be confidential and shall not be disclosed, except at the request of the health care professional, for the duration of the health care professional's participation in and upon successful completion of the program, provided such participation is in accordance with terms agreed upon by the department, the health care professional and the assistance program.

(j) (1) Any physician, hospital or state or local professional society or organization of health care professionals that refers a physician for intervention to the assistance program shall be deemed to have satisfied the obligations imposed on the person or organization pursuant to subsection (a) of section 20-13d, with respect to a physician's inability to practice medicine with reasonable skill or safety due to chemical dependency, emotional or behavioral disorder or physical or mental illness.

(2) Any physician, physician assistant, hospital or state or local professional society or organization of health care professionals that refers a physician assistant for intervention to the assistance program shall be deemed to have satisfied the obligations imposed on the person or organization pursuant to subsection (a) of section 20-12e, with respect to a physician assistant's inability to practice with reasonable skill or safety due to chemical dependency, emotional or behavioral disorder or physical or mental illness.

(k) The assistance program established pursuant to subsection (b) of this section shall meet with the Professional Assistance Oversight Committee established under section 19a-12b on a regular basis, but not less than four times each year.

(l) (1) On or before November first, annually, the assistance program shall select a person determined to be qualified by the assistance program and the Department of Public Health to conduct an audit on the premises of the assistance program for the purpose of examining quality control of the program and compliance with all requirements of this section. The Department of Public Health may waive the audit requirement, provided (A) the Professional Assistance Oversight Committee established under section 19a-12b has agreed to such waiver, in writing, and (B) the Department of Public Health has notified the Department of Consumer Protection of such waiver, in writing.

(2) Any audit conducted pursuant to this subsection shall consist of a random sampling of at least twenty per cent of the assistance program's files or ten files, whichever is greater. Prior to conducting the audit, the auditor shall agree in writing (A) not to copy any program files or records, (B) not to remove any program files or records from the premises, (C) to destroy all personally identifying information about health care professionals participating in the assistance program upon the completion of the audit, (D) not to disclose personally identifying information about health care professionals participating in the program to any person or entity other than a person employed by the assistance program who is authorized by such program to receive such disclosure, and (E) not to disclose in any audit report any personally identifying information about health care professionals participating in the assistance program.

(3) Upon completion of the audit conducted pursuant to this subsection, the auditor shall submit a written audit report to the assistance program, the Department of Public Health, the Professional Assistance Oversight Committee established under section 19a-12b and 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.

(P.A. 07-103, S. 1; P.A. 08-184, S. 23; P.A. 21-121, S. 26; P.A. 23-204, S. 255.)

History: P.A. 07-103 effective June 11, 2007; P.A. 08-184 made a technical change in Subsec. (e); P.A. 21-121 amended Subsec. (a)(3) by adding reference to Ch. 382a, effective July 1, 2021; P.A. 23-204 amended Subsec. (a) by adding Subdiv. (1) defining “assistance program”, redesignating existing Subdiv. (1) as Subdiv. (2), deleting former Subdiv. (2) defining “department”, redefining “medical review committee” in Subdiv. (4), deleting former Subdiv. (5) defining “assistance program,” adding new Subdiv. (5) defining “pharmacist” and adding Subdiv. (6) defining “pharmacy intern”, amended Subsec. (b) by adding references to pharmacists and pharmacy interns, Subdiv. (1) by adding references to Secs. 20-638 to 20-638b and Subdiv. (2) by designating existing provision re applicable provisions of Subsecs. (c) to (f) of section as Subpara. (A), adding Subpara. (B) re applicable provisions of Sec. 20-638a(b) to (h), redesignating existing Subparas. (A) and (B) as Subparas. (B)(i) and (B)(ii), adding reference to pharmacists and pharmacy interns in Subpara. (B)(i) and reference to pharmacy setting in Subpara. (B)(ii), substantially amended Subsec. (l) by dividing existing provisions into new Subdivs. (1) to (3), adding Subparas. (A) and (B) in Subdiv. (1) re waiver and redesignating former Subdivs. (1) to (5) as Subdivs. (2)(A) to (E), and made technical and conforming changes throughout.

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Sec. 19a-12b. Professional Assistance Oversight Committee. Duties. Access to professional assistance program records. Corrective action plans. Confidentiality of records and proceedings. (a) The Department of Public Health shall establish a Professional Assistance Oversight Committee for the assistance program. Such committee's duties shall include, but not be limited to, overseeing quality assurance. The oversight committee shall consist of the following members: (1) Three members selected by the Department of Public Health, who are health care professionals with training and experience in mental health or addiction services, (2) three members selected by the assistance program, who are not employees, board or committee members of the assistance program and who are health care professionals with training and experience in mental health or addiction services, and (3) one member selected by the Department of Mental Health and Addiction Services who is a health care professional.

(b) The assistance program shall provide administrative support to the oversight committee.

(c) Beginning January 1, 2008, the oversight committee shall meet with the assistance program on a regular basis, but not fewer than four times each year.

(d) The oversight committee may request and shall be entitled to receive copies of files or such other assistance program records it deems necessary, provided all information pertaining to the identity of any health care professional shall first be redacted by the assistance program. No member of the oversight committee may copy, retain or maintain any such redacted records. If the oversight committee determines that a health care professional is not able to practice with skill and safety or poses a threat to the health and safety of any person or patient in the health care setting, and the health care professional has not refrained from practicing health care or has failed to comply with terms or conditions of participation in the assistance program, the oversight committee shall notify the assistance program to refer the health care professional to the Department of Public Health. Upon such notification, the assistance program shall refer the health care professional to the Department of Public Health, in accordance with the provisions of subsection (i) of section 19a-12a.

(e) (1) If, at any time, the oversight committee determines that the assistance program (A) has not acted in accordance with the provisions of this section, section 19a-12a or sections 20-638 and 20-638a, or (B) requires remedial action based upon the audit performed under subsection (l) of section 19a-12a or subsection (j) of section 20-638a, the oversight committee shall notify the assistance program of such determination, in writing, not later than thirty days after such determination.

(2) The assistance program shall develop and submit to the oversight committee a corrective action plan addressing such determination not later than thirty days after the date of such notification. The assistance program may seek the advice and assistance of the oversight committee in developing the corrective action plan. Upon approval of the corrective action plan by the oversight committee, the oversight committee shall provide a copy of the approved plan to the assistance program, the Department of Public Health and, if the approved plan addresses pharmacists or pharmacy interns, the Department of Consumer Protection.

(3) (A) If the assistance program fails to comply with the corrective action plan, the oversight committee may (i) amend the plan, or (ii) direct the assistance program to refer some or all of the records of (I) the health care professionals in the assistance program to the Department of Public Health for a determination under subparagraph (B) of this subdivision, or (II) the pharmacists and pharmacy interns in the assistance program to the Department of Consumer Protection for a determination under subsection (f) of section 20-638a.

(B) Upon such referral, the Department of Public Health shall determine if each referred health care professional is eligible for continued intervention, rehabilitation, referral assistance or support services and whether participation in such intervention, rehabilitation, referral assistance or support services should be treated as confidential in accordance with subsection (h) of section 19a-12a. If the Department of Public Health determines that a health care professional is an appropriate candidate for confidential participation in continued intervention, referral assistance, rehabilitation or support services, the entire record of the referral and investigation of the health care professional shall be confidential and shall not be disclosed, except at the request of the health care professional, for the duration of the health care professional's participation in and upon successful completion of the program, provided such participation is in accordance with terms agreed upon by the department and the health care professional.

(4) Upon written notice to the Department of Public Health by the oversight committee that the assistance program is in compliance with a corrective action plan developed pursuant to subdivision (2) of this subsection, the department may refer health care professionals to the assistance program for continued intervention, rehabilitation, referral assistance or support services and shall submit to the assistance program all records and files concerning such health care professionals.

(f) Records created for, by or on behalf of the oversight committee shall not be deemed public records and shall not be subject to the provisions of section 1-210. Such records shall be treated as confidential in accordance with the provisions of subsection (h) of section 19a-12a and subsection (h) of section 20-638a.

(g) The proceedings of the oversight committee shall not be subject to discovery or introduced into evidence in any civil action for or against a health care professional, pharmacist or pharmacy intern arising out of matters that are subject to evaluation and review by such committee, and no person who was in attendance at such proceedings shall be permitted or required to testify in any such civil action as to the content of such proceedings. Nothing in this subdivision shall be construed to preclude (1) in any civil action, the use of any writing recorded independently of such proceedings; (2) in any civil action, the testimony of any person concerning such person's knowledge, acquired independently of such proceedings, about the facts that form the basis for the instituting of such civil action; (3) in any civil action arising out of allegations of patient harm caused by health care or pharmacy services rendered by a health care professional, pharmacist or pharmacy intern who, at the time such services were rendered, had been requested to refrain from practicing or whose practice of medicine, health care or pharmacy was restricted, the disclosure of such request to refrain from practicing or such restriction; or (4) in any civil action against a health care professional, pharmacist or pharmacy intern, disclosure of the fact that a health care professional, pharmacist or pharmacy intern participated in the assistance program, the dates of participation, the reason for participation and confirmation of successful completion of the program, provided a court of competent jurisdiction has determined that good cause exists for such disclosure after (A) notification to the health care professional, pharmacist or pharmacy intern of the request for such disclosure, and (B) a hearing concerning such disclosure at the request of any party, and provided further, the court imposes appropriate safeguards against unauthorized disclosure or publication of such information.

(P.A. 07-103, S. 2; P.A. 23-204, S. 256.)

History: P.A. 07-103 effective June 11, 2007; P.A. 23-204 amended Subsec. (e) by adding reference to Secs. 20-638 and 20-638a in Subdiv. (1)(A) and Sec. 20-638a(j) in Subdiv. (1)(B), adding provision re pharmacists, pharmacy interns and Department of Consumer Protection in Subdiv. (2), dividing Subdiv. (3) into Subparas. (A) and (B), dividing Subdiv. (3)(A) into clauses (i), (ii) and (ii)(I) and adding Subdiv. (3)(A)(ii)(II) re pharmacists, pharmacy interns and Department of Consumer Protection, amended Subsec. (f) by adding reference to Sec. 20-638a(h), amended Subsec. (g) by adding provisions re pharmacists, pharmacy interns, pharmacy services and practice of pharmacy, and made technical and conforming changes throughout.

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Sec. 19a-12e. Petition re inability of health care professional to practice with reasonable skill or safety. Report re arrest or disciplinary action. Investigation. Disclosure. Procedure. (a) As used in this section:

(1) “Assistance program” has the same meaning as provided in subsection (a) of section 19a-12a;

(2) “Health care professional” means any individual licensed or who holds a permit pursuant to chapter 368v, 370, 372, 373, 375 to 378, inclusive, 379 to 381b, inclusive, 382a, 383 to 385, inclusive, 388 or 397a to 399, inclusive; and

(3) “Hospital” has the same meaning as provided in section 19a-490.

(b) (1) Any health care professional or hospital shall, and any other person may, file a petition when such health care professional, hospital or person has any information that appears to show that a health care professional is, or may be, unable to practice his or her profession with reasonable skill or safety for any of the following reasons: (A) Physical illness or loss of motor skill, including, but not limited to, deterioration through the aging process; (B) emotional disorder or mental illness; (C) abuse or excessive use of drugs, including alcohol, narcotics or chemicals; (D) illegal, incompetent or negligent conduct in the practice of the profession of the health care professional; (E) possession, use, prescription for use or distribution of controlled substances or legend drugs, except for therapeutic or other medically proper purposes; (F) misrepresentation or concealment of a material fact in the obtaining or reinstatement of a license to practice the profession of the health care professional; or (G) violation of any provision of the chapter of the general statutes under which the health care professional is licensed or any regulation established under such chapter.

(2) A health care professional or hospital shall, and any other person may, file a petition described in this subsection not later than thirty days after obtaining information to support such petition. Each petition shall be filed with the Department of Public Health on forms supplied by the department, shall be signed and sworn and shall set forth in detail the matters complained of.

(c) Any health care professional or hospital that refers a health care professional for intervention to the assistance program shall be deemed to have satisfied the obligations imposed on the health care professional or hospital pursuant to this section with respect to a health care professional's inability to practice with reasonable skill or safety due to chemical dependency, emotional or behavioral disorder or physical or mental illness.

(d) A health care professional who has been the subject of an arrest arising out of an allegation of the possession, use, prescription for use or distribution of a controlled substance or legend drug or alcohol shall, not less than thirty days after such arrest, notify the Department of Public Health. The health care professional shall be deemed to satisfy this obligation if the health care professional seeks intervention with the assistance program.

(e) A health care professional shall report to the department any disciplinary action similar to an action specified in subsection (a) of section 19a-17 taken against the health care professional by a duly authorized professional disciplinary agency of any state, the District of Columbia, a United States possession or territory or a foreign jurisdiction, not later than thirty days after such action. Failure to report in accordance with the provisions of this subsection may constitute a ground for disciplinary action under section 19a-17.

(f) No health care professional, hospital or person filing a petition in accordance with the provisions of this section or providing information to the department or the assistance program shall, without a showing of malice, be liable for damage or injury to the health care professional. The assistance program shall not be liable for damage or injury to the health care professional without a showing of malice.

(g) The department shall investigate each petition filed pursuant to this section in accordance with the provisions of subdivisions (10) and (11) of subsection (a) of section 19a-14, to determine if probable cause exists to issue a statement of charges and to institute proceedings against the health care professional under subsection (j) of this section. Such investigation shall be concluded not later than eighteen months after the date the petition is filed with the department and, unless otherwise specified by this subsection, the record of such investigation shall be deemed a public record, in accordance with section 1-210, at the conclusion of such eighteen-month period. Any such investigation shall be confidential prior to the conclusion of such eighteen-month period and no person shall disclose his or her knowledge of such investigation to a third party unless the health care professional requests that such investigation and disclosure be open, except the department shall provide information to the person who filed the petition as provided in subdivision (12) of subsection (a) of section 19a-14. If the department determines that probable cause exists to issue a statement of charges, the entire record of such proceeding shall be public unless the department determines that the health care professional is an appropriate candidate for participation in the assistance program. If at any time subsequent to the filing of a petition and during the eighteen-month period following the filing of the petition, the department makes a finding of no probable cause, the petition and the entire record of such investigation shall remain confidential, except as provided in subdivision (12) of subsection (a) of section 19a-14, unless the health care professional requests that such petition and record be open.

(h) As part of an investigation of a petition filed pursuant to this section, the department may order the health care professional to submit to a physical or mental examination to be performed by a physician or an advanced practice registered nurse chosen from a list approved by the department. The department may seek the advice of established medical organizations or licensed health professionals in determining the nature and scope of any diagnostic examinations to be used as part of any such physical or mental examination. The chosen physician or advanced practice registered nurse shall make a written statement of his or her findings.

(i) If the health care professional fails to obey a department order to submit to examination or attend a hearing, the department may petition the superior court for the judicial district of Hartford to order such examination or attendance, and said court or any judge assigned to said court shall have jurisdiction to issue such order.

(j) Subject to the provisions of section 4-182, no license shall be restricted, suspended or revoked by the Department of Public Health, and no health care professional's right to practice shall be limited by the department, until the health care professional has been given notice and opportunity for hearing in accordance with said section.

(June Sp. Sess. P.A. 15-5, S. 480; P.A. 16-39, S. 16; 16-66, S. 3; P.A. 17-178, S. 1; P.A. 21-121, S. 28; P.A. 23-204, S. 257.)

History: P.A. 16-39 amended Subsec. (h) by adding references to advanced practice registered nurse; P.A. 16-66 amended Subsec. (a)(1) by replacing “person” with “individual” and adding references to Chs. 368v, 370, 381b, 388 and 397a to 399; P.A. 17-178 amended Subsec. (d) by deleting provision re notice to department when diagnosed with mental illness or behavioral or emotional disorder and making a conforming change; P.A. 21-121 amended Subsec. (a)(1) by adding reference to Ch. 382a; P.A. 23-204 amended Subsec. (a) by adding Subdiv. (1) defining “assistance program”, redesignating existing Subdiv. (1) as new Subdiv. (2), deleting former Subdiv. (2) defining “assistance program” and made a conforming change in Subdiv. (2).

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Sec. 19a-17d. Prohibition on automatic reciprocal discipline based solely on the termination of a pregnancy. If a pharmacist or health care professional who is currently licensed or was previously licensed in another state or jurisdiction is subject to automatic reciprocal discipline for a disciplinary action in such state or jurisdiction, such automatic reciprocal discipline shall be automatically rescinded and shall not be entered into the licensing record of the pharmacist or health care professional if the discipline was based solely on the termination of pregnancy under conditions that would not violate the general statutes or the regulations of Connecticut state agencies. The provisions of this section shall not preclude or affect the ability of an agency or board of the state to seek or impose any discipline pursuant to the general statutes against a pharmacist or other health care professional licensed by the state.

(P.A. 23-31, S. 18.)

History: P.A. 23-31 effective July 1, 2023.

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Sec. 19a-17e. Adverse permit or licensure eligibility action based on provision of reproductive health care services prohibited. (a) As used in this section, “reproductive health care services” has the same meaning as provided in section 52-571m.

(b) Notwithstanding the provisions of subsection (a) of section 19a-14, the Department of Public Health shall not deny the eligibility of an applicant for a (1) permit, (2) license by examination, endorsement or reciprocity, or (3) reinstatement of a license (A) voided pursuant to the provisions of subsection (f) of section 19a-88, (B) voluntarily surrendered, or (C) by agreement, not renewed or reinstated pursuant to the provisions of subsection (d) of section 19a-17 based on pending disciplinary action, an unresolved complaint or the imposition of disciplinary action against the applicant by a duly authorized professional disciplinary agency of another state, the District of Columbia or a commonwealth, territory or possession of the United States that is based solely on the alleged provision of, receipt of, assistance in provision or receipt of, material support for, or any theory of vicarious, joint, several or conspiracy liability derived therefrom, reproductive health care services that are permitted under the laws of this state and were provided in accordance with the standard of care applicable to such services, regardless of whether the patient receiving such services was a resident of this state. The provisions of this subsection shall not apply where the underlying conduct of the applicant would constitute the basis of disciplinary action against the applicant under the laws of this state if the applicant had been licensed or permitted in this state and the conduct had occurred in this state.

(c) Notwithstanding the provisions of section 19a-17, a board or commission established under title 20 that has jurisdiction over persons licensed, certified or registered under said title who provide reproductive health care services, and the Department of Public Health, with respect to professions under the department's jurisdiction that are not subject to discipline by such a board or commission, shall not impose disciplinary action against a licensed, certified or registered person based on pending disciplinary action, an unresolved complaint or the imposition of disciplinary action against such persons before or by a duly authorized professional disciplinary agency of another state, the District of Columbia, or a commonwealth, territory or possession of the United States that is based solely on the alleged provision of, receipt of, assistance in provision or receipt of, material support for, or any theory of vicarious, joint, several or conspiracy liability derived therefrom, reproductive health care services that are permitted under the laws of this state and were provided in accordance with the standard of care applicable to such services, regardless of whether the patient receiving such services was a resident of this state. The provisions of this subsection shall not apply where the underlying conduct of the licensed, certified or registered person would constitute the basis of disciplinary action against such person under the laws of this state if the conduct had occurred in this state.

(P.A. 23-128, S. 1.)

History: P.A. 23-128 effective June 27, 2023.

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Sec. 19a-25. (Formerly Sec. 19-6a). Confidentiality of records procured by the Department of Public Health or directors of health of towns, cities or boroughs. (a) All information, records of interviews, written reports, statements, notes, memoranda or other data, including personal data as defined in subdivision (9) of section 4-190, procured by: (1) The Department of Public Health, by staff committees of facilities accredited by the Department of Public Health, the maternity mortality review committee, established pursuant to section 19a-59i, or the infant mortality review committee, established pursuant to section 19a-59k, in connection with studies of morbidity and mortality conducted by the Department of Public Health, such staff committees, the maternal mortality review committee or the infant mortality review committee, or carried on by said department, such staff committees or the maternal mortality review committee jointly with other persons, agencies or organizations, (2) the directors of health of towns, cities or boroughs or the Department of Public Health pursuant to section 19a-215, or (3) the Department of Public Health or such other persons, agencies or organizations, for the purpose of reducing the morbidity or mortality from any cause or condition, shall be confidential and shall be used solely for the purposes of medical or scientific research and, for information obtained pursuant to section 19a-215, disease prevention and control by the local director of health and the Department of Public Health and reducing the morbidity or mortality from any cause or condition. Such information, records, reports, statements, notes, memoranda or other data shall not be admissible as evidence in any action of any kind in any court or before any other tribunal, board, agency or person, nor shall it be exhibited or its contents disclosed in any way, in whole or in part, by any officer or representative of the Department of Public Health or of any such facility, by any person participating in such a research project or by any other person, except as may be necessary for the purpose of furthering the research project or public health use to which it relates.

(b) Notwithstanding the provisions of chapter 55, the Department of Public Health may exchange personal data for the purpose of medical or scientific research, with any other governmental agency or private research organization; provided such state, governmental agency or private research organization shall not further disclose such personal data. The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, consistent with the purposes of this section to establish the procedures to ensure the confidentiality of such disclosures. The furnishing of such information to the Department of Public Health or its authorized representative, or to any other agency cooperating in such a research project, shall not subject any person, hospital, behavioral health facility, rest home, nursing home or other person or agency furnishing such information to any action for damages or other relief because of such disclosure.

(c) The provisions of this section shall not affect: (1) Disclosure of regular hospital and medical records made in the course of the regular notation of the care and treatment of any patient, but only records or notations by the staff committees described in subsection (a) of this section pursuant to their work, or (2) release by the Department of Public Health of annual immunization rates for each public and nonpublic school in the state pursuant to section 10-204a.

(1961, P.A. 358; 1971, P.A. 811; P.A. 77-346; 77-614, S. 323, 587, 610; P.A. 78-303, S. 85, 136; P.A. 84-380, S. 3; P.A. 93-291, S. 1; 93-381, S. 9, 39; 93-435, S. 59, 95; P.A. 95-257, S. 12, 21, 58; P.A. 18-150, S. 1; P.A. 21-6, S. 2; P.A. 23-147, S. 12.)

History: 1971 act made provisions applicable to data procured by staff committees of accredited facilities, excluded studies of “maternal and perinatal” morbidity and rewrote provision re effect of provisions on disclosure of regular hospital and medical records; P.A. 77-346 specifically included as confidential records “personal data as defined in subsection (i) of section 4-190” and added provision re exchange of personal data for research purposes between health department and other agencies and organizations; P.A. 77-614 and P.A. 78-303 replaced commissioner and department of health with commissioner and department of health services, effective January 1, 1979; Sec. 19-6a transferred to Sec. 19a-25 in 1983; P.A. 84-380 made technical change to reflect numbering of Subdivs. in Sec. 4-190; P.A. 93-291 applied provisions to records and information procured by the department or local health directors concerning communicable diseases; P.A. 93-381 and P.A. 93-435 replaced department and commissioner of health services with department and commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 18-150 added references to maternal mortality review committee, and made technical changes; P.A. 21-6 designated existing provisions as Subsecs. (a), (b) and (c) and amended same by making technical changes and further amended Subsec. (a) by adding Subdiv. designators (1) to (3), Subsec. (b) by replacing “sanitarium” with “behavioral health facility” and Subsec. (c) by designating existing provision as Subdiv. (1) and adding Subdiv. (2) re release of annual school immunization rates, effective April 28, 2021; P.A. 23-147 amended Subsec. (a) by adding references to infant mortality review committee and making conforming changes in Subdiv. (1), adding “the Department of Public Health or” and “and reducing the morbidity or mortality from any cause or condition” in Subdiv. (3), and adding “or public health use”.

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Sec. 19a-25g. Provision of electronic copy of medical records by one health care institution to another at the request of the patient. (a) Each institution, as defined in section 19a-490, except a facility operated by the Department of Mental Health and Addiction Services and the hospital and psychiatric residential treatment facility units of the Albert J. Solnit Children's Center, shall, upon receipt of a medical records request directed by the patient or the patient's representative, provide an electronic copy of such patient's medical records to another such institution (1) as soon as feasible, but not later than six days after such request is received by the institution, if such request is urgent, or (2) not later than seven business days after such request is received, if such request is not urgent. Notwithstanding any other provision of the general statutes, an institution providing an electronic copy of a patient's medical records pursuant to the provisions of this section shall not be required to obtain specific written consent from such patient before providing such electronic copy.

(b) The provisions of subsection (a) of this section shall not be construed to require an institution to provide records (1) in violation of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended from time to time, or 45 CFR 160.101 to 45 CFR 164.534, inclusive, as amended from time to time, (2) in response to a direct request from another health care provider, unless such provider can validate that such provider has a health provider relationship with the patient whose records are being requested, or (3) in response to a third-party request.

(P.A. 23-97, S. 43.)

History: P.A. 23-97 effective January 1, 2024.

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Sec. 19a-32n. Information re umbilical cord blood collection programs. A physician or other health care provider who provides health care services to a pregnant woman during the last trimester of her pregnancy, which health care services are directly related to her pregnancy, shall provide the woman with timely, relevant and appropriate information sufficient to allow her to make an informed and voluntary choice regarding options to bank or donate umbilical cord blood following the delivery of a newborn child.

(P.A. 09-232, S. 21; P.A. 11-160, S. 9; P.A. 23-204, S. 238.)

History: P.A. 09-232 effective July 1, 2009; P.A. 11-160 designated existing provision as Subsec. (a) and added Subsec. (b) re Connecticut Umbilical Cord Blood Collection Board's public education and marketing activities, effective July 13, 2011; P.A. 23-204 deleted former Subsec. (b) re Connecticut Umbilical Cord Blood Collection Board's public education and marketing activities and deleted Subsec. (a) designator, effective July 1, 2023.

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(P.A. 11-160, S. 1–8; P.A. 23-204, S. 444.)

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Sec. 19a-36j. Food inspectors. Certification. Employment restrictions. Inspections. (a) No person shall engage in the practice of a food inspector unless such person has obtained a certification from the commissioner in accordance with the provisions of this section. The commissioner shall develop a training and verification program for food inspector certification that shall be administered by the food inspection training officer at a local health department.

(1) Each person seeking certification as a food inspector shall submit an application to the department on a form prescribed by the commissioner and present to the department satisfactory evidence that such person (A) possesses a bachelor's degree or three years of experience in a regulatory food protection program, (B) has successfully completed a training and verification program prescribed by the commissioner, and (C) has successfully completed the field standardization inspection prescribed by the commissioner.

(2) Certifications issued under this section shall be subject to renewal once every three years. A food inspector applying for renewal of his or her certification shall demonstrate successful completion of twenty contact hours in food protection training, as approved by the commissioner, and reassessment by the food inspection training officer.

(b) No person shall be employed as a certified food inspector if such person, such person's immediate family, as defined in section 1-79, or a business with which such person is associated, as described in subdivision (2) of section 1-79, (1) has any financial or ownership interest in a food establishment located in the jurisdiction in which such person is employed as a food inspector, (2) engages in any business, employment or management of a food establishment located in such jurisdiction, or (3) owns the property on which a food establishment is located in such jurisdiction.

(c) Each director of health employing a food inspector shall certify, on a form prescribed by the commissioner, that such food inspector is not prohibited from employment as a food inspector pursuant to the provisions of subsection (b) of this section.

(d) A certified food inspector shall conduct an inspection of a food establishment in a form and manner prescribed by the commissioner to determine compliance with the food code. The director of health shall ensure all food establishments are inspected at a frequency determined by their risk classification. Such director of health shall evaluate the food establishment's risk classification on an annual basis to determine accuracy. More frequent inspections may be conducted to ensure compliance with the food code. Each food establishment classification shall be inspected pursuant to the following schedule:

(1) Class 1 food establishments shall be inspected at intervals not to exceed three hundred sixty days.

(2) Class 2 food establishments shall be inspected at intervals not to exceed one hundred eighty days.

(3) Class 3 food establishments shall be inspected at intervals not to exceed one hundred twenty days.

(4) Class 4 food establishments shall be inspected at intervals not to exceed ninety days.

(5) Temporary food service establishments shall be inspected prior to the issuance of a permit to operate and as often as necessary to ensure compliance with the food code.

(P.A. 17-93, S. 5; P.A. 18-168, S. 47; P.A. 21-121, S. 62; P.A. 23-31, S. 26.)

History: P.A. 18-168 amended Subsec. (a) by replacing “July 1, 2018” with “January 1, 2019”, effective June 13, 2018; P.A. 21-121 amended Subsec. (a) by replacing “January 1, 2019” with “January 1, 2023”, effective July 6, 2021; P.A. 23-31 amended Subsec. (a) by deleting “On and after January 1, 2023” and making a conforming change, deleting Subdiv. (1)(A), redesignating Subdiv. (1)(B) to (1)(D) as Subdiv. (1)(A) to (1)(C), adding “prescribed by the commissioner, and” to Subdiv. (1)(B), deleting Subdiv. (1)(E), deleting Subdiv. (2), redesignating existing Subdiv. (3) as Subdiv. (2) and making conforming changes, added new Subsec. (b) re employment restrictions, added Subsec. (c) re certification re employment restrictions, and redesignated existing Subsec. (b) as Subsec. (d), effective January 1, 2024.

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Sec. 19a-36p. Posting on menus and menu boards of request for customers to notify server of any food allergies. Not later than January 1, 2025, each class 2, class 3 and class 4 food establishment, as defined in section 19a-36g, shall post in a clear and conspicuous manner on its menus and menu boards a request for customers to notify their server, prior to placing an order, of any food allergies.

(P.A. 23-115, S. 1.)

History: P.A. 23-115 effective July 1, 2023.

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Sec. 19a-36q. Informational poster regarding food allergies for food establishments. Displaying of poster. (a) Not later than December 1, 2023, the Department of Public Health shall develop or approve an informational poster regarding food allergies for display in class 2, class 3 and class 4 food establishments, as defined in section 19a-36g. The poster shall contain information concerning (1) the most common allergy-causing foods, (2) the actions a server should take when a customer notifies the server that the customer has a food allergy, (3) the ways in which kitchen staff and servers can prevent cross contact of foods, and (4) the need to contact the 911 emergency telecommunications number if a customer has an allergic reaction while on the premises of such food establishment.

(b) Not later than March 1, 2024, (1) each class 2, class 3 and class 4 food establishment shall display the poster developed or approved pursuant to subsection (a) of this section in a clear and conspicuous manner in its kitchen or designated staff area, and (2) the certified food protection manager, as defined in section 19a-36g, of each class 2, class 3 and class 4 food establishment shall ensure that each employee of the food establishment has viewed the poster and require each employee to confirm, in writing, that the employee has familiarized himself or herself with the information displayed in the poster. Failure to display the poster shall be grounds for an inspection violation under section 19a-36l.

(P.A. 23-115, S. 2.)

History: P.A. 23-115 effective June 27, 2023.

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Sec. 19a-36r. Local health department food protection program audits. The Commissioner of Public Health may conduct audits of local health department food protection programs. Such audits may include, but need not be limited to, interviews with local health department staff members and joint inspections with local health department staff members of local food establishments. Upon the conclusion of any such audit, the Commissioner of Public Health shall provide the local director of health with a report detailing such audit's findings and any recommended or necessary corrective actions to be taken by such director.

(P.A. 23-31, S. 27.)

History: P.A. 23-31 effective June 7, 2023.

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Sec. 19a-40a. Criminal history records checks required for applicants for employment in the vital records unit. The Commissioners of Public Health and Administrative Services shall require each applicant for employment in, and each employee applying for transfer to, the vital records unit of the Department of Public Health to (1) state whether such applicant or employee has ever been convicted of a crime or whether criminal charges are pending against such applicant or employee at the time of application for employment or transfer, and (2) submit to state and national criminal history records checks. The criminal history records checks required pursuant to this section shall be conducted in accordance with section 29-17a.

(P.A. 07-79, S. 1; P.A. 23-204, S. 100.)

History: P.A. 23-204 added reference to Commissioner of Administrative Services, effective June 12, 2023.

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Sec. 19a-42. (Formerly Sec. 19-15a). Amendment of vital records. (a) To protect the integrity and accuracy of vital records, a certificate registered under chapter 93 may be amended only in accordance with sections 19a-41 to 19a-45, inclusive, chapter 93, regulations adopted by the Commissioner of Public Health pursuant to chapter 54 and uniform procedures prescribed by the commissioner. Only the commissioner may amend birth certificates to reflect changes concerning parentage or the legal name of a parent or birth or marriage certificates to reflect changes concerning gender. Amendments related to parentage, gender change or the legally changed name of a parent shall result in the creation of a replacement certificate that supersedes the original, and shall in no way reveal the original language changed by the amendment. Any amendment to a vital record made by the registrar of vital statistics of the town in which the vital event occurred or by the commissioner shall be in accordance with such regulations and uniform procedures.

(b) The commissioner and the registrar of vital statistics shall maintain sufficient documentation, as prescribed by the commissioner, to support amendments and shall ensure the confidentiality of such documentation as required by law. The date of amendment and a summary description of the evidence submitted in support of the amendment shall be endorsed on or made part of the record and the original certificate shall be marked “Amended”, except for amendments concerning parentage, gender change or the legally changed name of a parent. When the registrar of the town in which the vital event occurred amends a certificate, such registrar shall, within ten days of making such amendment, forward an amended certificate to the commissioner and to any registrar having a copy of the certificate. When the commissioner amends a birth certificate, including changes concerning parentage, gender change or the legally changed name of a parent, the commissioner shall forward an amended certificate to the registrars of vital statistics affected and their records shall be amended accordingly.

(c) An amended certificate shall supersede the original certificate that has been changed and shall be marked “Amended”, except for amendments concerning parentage, gender change or the legally changed name of a parent. The original certificate in the case of amendments concerning parentage, gender change or the legally changed name of a parent shall be physically or electronically sealed and kept in a confidential file by the department and the registrar of any town in which the birth was recorded, and may be unsealed for issuance only as provided in section 7-53 with regard to an original birth certificate or upon a written order of a court of competent jurisdiction. The amended certificate shall become the official record.

(d) (1) Upon receipt of (A) an acknowledgment of parentage executed in accordance with the provisions of sections 46b-476 to 46b-487, inclusive, by both parents of a child, or (B) a certified copy of an order of a court of competent jurisdiction establishing the parentage of a child, the commissioner shall include on or amend, as appropriate, such child's birth certificate to show such parentage if parentage is not already shown on such birth certificate and to change the name of the child under eighteen years of age if so indicated on the acknowledgment of parentage form or within the certified court order as part of the parentage action. If a person who is the subject of a voluntary acknowledgment of parentage, as described in this subdivision, is eighteen years of age or older, the commissioner shall obtain a notarized affidavit from such person affirming that such person agrees to the commissioner's amendment of such person's birth certificate as such amendment relates to the acknowledgment of parentage. The commissioner shall amend the birth certificate for an adult child to change the child's name only pursuant to a court order.

(2) If the birth certificate lists the information of a parent other than the parent who gave birth, the commissioner shall not remove or replace the parent's information unless presented with a certified court order that meets the requirements specified in section 7-50, or upon the proper filing of a rescission, in accordance with the provisions of section 46b-570. The commissioner shall thereafter amend such child's birth certificate to remove or change the name of the parent other than the person who gave birth and, if relevant, to change the name of the child, as requested at the time of the filing of a rescission, in accordance with the provisions of section 46b-570. Birth certificates amended under this subsection shall not be marked “Amended”.

(e) When the parent or parents of a child request the amendment of the child's birth certificate to reflect a new name of the parent who gave birth because the name on the original certificate is fictitious, such parent or parents shall obtain an order of a court of competent jurisdiction declaring the person who gave birth to be the child's parent. Upon receipt of a certified copy of such order, the department shall amend the child's birth certificate to reflect the parent's true name.

(f) Upon receipt of a certified copy of an order of a court of competent jurisdiction changing the name of a person born in this state and upon request of such person or such person's parents, guardian, or legal representative, the commissioner or the registrar of vital statistics of the town in which the vital event occurred shall amend the birth certificate to show the new name by a method prescribed by the department.

(g) When an applicant submits the documentation required by the regulations to amend a vital record, the commissioner shall hold a hearing, in accordance with chapter 54, if the commissioner has reasonable cause to doubt the validity or adequacy of such documentation.

(h) When an amendment under this section involves the changing of existing language on a death certificate due to an error pertaining to the cause of death, the death certificate shall be amended in such a manner that the original language is still visible. A copy of the death certificate shall be made. The original death certificate shall be sealed and kept in a confidential file at the department and only the commissioner may order it unsealed. The copy shall be amended in such a manner that the language to be changed is no longer visible. The copy shall be a public document.

(i) The commissioner shall issue a new birth certificate to reflect a gender change upon receipt of the following documents submitted in the form and manner prescribed by the commissioner: (1) A written request from the applicant, signed under penalty of law, for a replacement birth certificate to reflect that the applicant's gender differs from the sex designated on the original birth certificate; (2) a notarized affidavit by a physician licensed pursuant to chapter 370 or holding a current license in good standing in another state, a physician assistant licensed pursuant to chapter 370 or holding a current license in good standing in another state, an advanced practice registered nurse licensed pursuant to chapter 378 or holding a current license in good standing in another state, or a psychologist licensed pursuant to chapter 383 or holding a current license in good standing in another state, stating that the applicant has undergone surgical, hormonal or other treatment clinically appropriate for the applicant for the purpose of gender transition; and (3) if an applicant is also requesting a change of name listed on the original birth certificate, proof of a legal name change. The new birth certificate shall reflect the new gender identity by way of a change in the sex designation on the original birth certificate and, if applicable, the legal name change.

(j) The commissioner shall issue a new birth certificate to reflect the legally changed name of a parent of a minor child who is the subject of such birth certificate upon receipt of the following documents, submitted in a form and manner prescribed by the commissioner: (1) A written request from the parent, signed under penalty of law, for a replacement birth certificate to reflect that the parent's legal name differs from the name designated on the original birth certificate, and (2) a certified copy of an order of a court of competent jurisdiction changing such parent's name. The commissioner shall issue a new birth certificate to an adult child who is the subject of such birth certificate and wishes to change the name of a parent who has legally changed such parent's name upon presentation by such adult child to the commissioner of a certified copy of an order of a court of competent jurisdiction changing such parent's name.

(k) The commissioner shall issue a new marriage certificate to reflect a gender change upon receipt of the following documents, submitted in a form and manner prescribed by the commissioner: (1) A written request from the applicant, signed under penalty of law, for a replacement marriage certificate to reflect that the applicant's gender differs from the sex designated on the original marriage certificate, along with an affirmation that the marriage is still legally intact; (2) a notarized statement from the spouse named on the marriage certificate to be amended, consenting to the amendment; (3) (A) a United States passport or amended birth certificate or court order reflecting the applicant's gender as of the date of the request, or (B) a notarized affidavit by a physician licensed pursuant to chapter 370 or holding a current license in good standing in another state, physician assistant licensed pursuant to chapter 370 or holding a current license in good standing in another state, an advanced practice registered nurse licensed pursuant to chapter 378 or holding a current license in good standing in another state or a psychologist licensed pursuant to chapter 383 or holding a current license in good standing in another state stating that the applicant has undergone surgical, hormonal or other treatment clinically appropriate for the applicant for the purpose of gender transition; and (4) if an applicant is also requesting a change of name listed on the original marriage certificate, proof of a legal name change. The new marriage certificate shall reflect the new gender identity by way of a change in the sex designation on the original marriage certificate and, if applicable, the legal name change.

(P.A. 79-434, S. 11; P.A. 90-168; P.A. 91-252, S. 4; P.A. 93-97, S. 1, 2; 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; June 18 Sp. Sess. P.A. 97-7, S. 12, 38; June 18 Sp. Sess. P.A. 97-8, S. 44; June 18 Sp. Sess. P.A. 97-10, S. 3; P.A. 01-163, S. 32; P.A. 03-19, S. 48; P.A. 04-255, S. 14, 15; 04-257, S. 35; June Sp. Sess. P.A. 09-3, S. 166; P.A. 11-219, S. 3; P.A. 14-133, S. 8; 14-231, S. 2; P.A. 15-132, S. 1; P.A. 21-15, S. 96; 21-121, S. 77; P.A. 23-204, S. 303.)

History: Sec. 19-15a transferred to Sec. 19a-42 in 1983; P.A. 90-168 added Subsec. (f) on the amendment of death certificates; P.A. 91-252 amended Subsec. (b) by deleting phrase “except as otherwise provided in this section”, adding “on the original” and by adding provisions specifying that original birth, death or marriage certificate shall be sealed and kept in confidential file at department of health services and may be unsealed only upon order of commissioner, that a copy of original shall be made and shall be amended so that changed language is no longer visible and that the copy shall be a public record; P.A. 93-97 amended Subsec. (c) to add a $25 fee for amendment of a birth certificate to show paternity, effective July 1, 1993; P.A. 93-381 replaced department and commissioner of health services with department and commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; June 18 Sp. Sess. P.A. 97-7 amended Subsec. (c) by deleting requirement of written request of both parents and adding provision that birth certificate shall include or be amended to include paternity upon receipt of voluntary acknowledgment of paternity or certified court order establishing paternity, removal only upon filing of rescission of paternity or upon court order and by providing for fee of $25 for each amendment to birth certificate, effective July 1, 1997; June 18 Sp. Sess. P.A. 97-8 added new Subsec. (e) re specific authority for department to amend birth certificate to reflect gender of a person born with hermaphroditism and redesignated former Subsecs. (e) and (f) accordingly; June 18 Sp. Sess. P.A. 97-10 deleted changes enacted by June 18 Sp. Sess. P.A. 97-8, except for the addition of a comma following reference to “vital records” in Subsec. (a); P.A. 01-163 amended Subsec. (a) by adding provisions re uniform procedures prescribed by the commissioner, deleting provision re report of amendment to affected registrars and adding provisions re amendments concerning parentage or gender change and amendments made by registrar, deleted former Subsec. (b), added new Subsecs. (b) and (c), redesignated former Subsec. (c) as Subsec. (d) and amended by deleting “voluntary”, changing “surname” to “name”, adding provision re father's information and making technical changes in Subdiv. (1), revising provision re filing of rescission, deleting provision re court order and adding provision re changing the name of child and reference to Sec. 7-50 in Subdiv. (2) and making a technical change in Subdiv. (3), added new Subsec. (e), redesignated former Subsec. (d) as Subsec. (f) and amended by adding provisions re registrar of the town in which the vital event occurred and method prescribed by the department and making technical changes, and redesignated former Subsecs. (e) and (f) as Subsecs. (g) and (h) and amended by making technical changes; P.A. 03-19 made technical changes in Subsec. (e), effective May 12, 2003; P.A. 04-255 amended Subsec. (a) by requiring commissioner to make amendments in accordance with regulations and uniform procedures and amended Subsec. (d) by replacing provisions in Subdiv. (1) re changing name of child, removal or replacement of father's information and making of certificate, with provision re changing name of child if indicated on form or within order, and by adding provisions in Subdiv. (2) requiring that no father's information be removed without a court order or filing of a rescission and that certificates amended under section not be marked “amended”; P.A. 04-257 made a technical change in Subsec. (c), effective June 14, 2004; June Sp. Sess. P.A. 09-3 amended Subsec. (d)(3) to increase fee from $25 to $50; P.A. 11-219 deleted former Subsec. (d)(3) re fee for amendment to birth certificate; P.A. 14-133 amended Subsec. (c) by deleting reference to viewing original certificate, adding reference to Sec. 7-53 and replacing “public record” with “official record”, effective July 1, 2015; P.A. 14-231 amended Subsec. (d)(1) by adding “under eighteen years of age” and adding provisions re commissioner to obtain notarized affidavit and amend birth certificate for person 18 years of age or older; P.A. 15-132 added Subsec. (i) re issuance of new birth certificate to reflect a gender change; P.A. 21-15 amended Subsec. (d)(1) by replacing “paternity” with “parentage”, replacing “subsection (a) of section 46b-172” with “sections 46b-476 to 46b-487, inclusive,” deleting “born out of wedlock” and by making technical changes, amended Subsec. (d)(2) by replacing “another father is listed on the birth certificate” with “the birth certificate lists the information of a parent other than the person who gave birth”, replacing “father's information” with “parent's information”, replacing “change the father's name” with “change the name of the parent other than the person who gave birth” and by adding “if relevant” re commissioner changing the name of child on birth certificate, and amended Subsec. (e) by replacing “mother's name” with “name of the parent who gave birth”, “putative mother” with “person who gave birth” and replacing “mother” with “parent”, effective January 1, 2022; P.A. 21-121 amended Subsec. (a) by adding “birth or marriage certificates to reflect changes concerning”, amended Subsec. (c) by adding “with regard to an original birth certificate”, amended Subsec. (i) by adding reference to physician assistant and added Subsec. (j) re issuance of new marriage certificate to reflect gender change; P.A. 23-204 amended Subsecs. (a) to (c) by adding changes concerning the legally changed name of a parent and conforming technical changes, inserted new Subsec. (j) re issuance of new birth certificates and redesignated existing Subsec. (j) as Subsec. (k), effective July 1, 2023.

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Sec. 19a-55. (Formerly Sec. 19-21b). Newborn screening program. Tests required. Report to Department of Public Health. Exemptions. Regulations. (a) There is established a newborn screening program. 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, subject to the approval of the Secretary of the Office of Policy and Management. The fees to be charged pursuant to subdivision (3) of this subsection shall be set at a minimum of ninety-eight dollars.

(b) The administrative officer or other person in charge of each institution caring for newborn infants, a nurse-midwife licensed pursuant to chapter 377 or a midwife shall cause to have administered to every such newborn infant in his or her care a blood spot specimen and an HIV-related test, as defined in section 19a-581, except that the person responsible for testing may omit such test if the mother has had an HIV-related test pursuant to section 19a-90 or 19a-593. The blood spot specimen shall be collected not earlier than twenty-four hours after the birth of the newborn infant and not later than forty-eight hours after the birth of such infant, unless the institution caring for newborn infants, nurse-midwife licensed pursuant to chapter 377 or midwife determines that a situation exists to warrant an early collection of the specimen or if collection of the specimen is medically contraindicated. Situations that warrant early collection of the specimen shall include, but not be limited to, the imminent transfusion of blood products, dialysis, early discharge of the newborn infant from the institution, transfer of the newborn infant to another institution or imminent death. If the newborn infant dies before a blood spot specimen can be obtained, the specimen shall be collected as soon as practicable after death. The institution licensed to care for newborn infants, nurse-midwife or midwife shall notify the Department of Public Health when a specimen is not collected within forty-eight hours after the birth of such infant due to: (1) The infant's medical fragility, (2) refusal by the parents when newborn infant screening is in conflict with their religious tenets and practice, (3) the newborn infant receiving comfort measures only, or (4) any other reason. Such notification shall be documented in the department's newborn screening system pursuant to section 19a-53 by the institution caring for newborn infants, nurse-midwife or midwife or sent in writing to the department not later than seventy-two hours after the birth of the newborn infant. The institution caring for newborn infants, nurse-midwife or midwife shall send the blood spot specimen to the state public health laboratory not later than twenty-four hours after the time of collection. The department may request an additional blood spot specimen if: (A) There was an early collection of the specimen, (B) the specimen was collected following a transfusion of blood products, (C) the specimen is unsatisfactory for testing, or (D) the department determines that there is an abnormal result. The state public health laboratory shall make and maintain a record of the date and time of its receipt of each blood spot specimen and make such record available for inspection by the institution caring for newborn infants, nurse-midwife or midwife that sent the blood spot specimen not later than forty-eight hours after such institution, nurse-midwife or midwife submits a request to inspect such record.

(c) 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, but need not be limited to, testing for (1) amino acid disorders, including phenylketonuria, organic acid disorders, fatty acid oxidation disorders, including, but not limited to, long-chain 3-hydroxyacyl CoA dehydrogenase (L-CHAD) and medium-chain acyl-CoA dehydrogenase (MCAD), hypothyroidism, galactosemia, sickle cell disease, maple syrup urine disease, homocystinuria, biotinidase deficiency, congenital adrenal hyperplasia, severe combined immunodeficiency disease, adrenoleukodystrophy, spinal muscular atrophy and any other disorder included on the recommended uniform screening panel pursuant to 42 USC 300b-10, as amended from time to time, and as prescribed by the Commissioner of Public Health, and (2) on and after July 1, 2025, cytomegalovirus.

(d) In addition to the testing requirements prescribed in subsection (b) of this section, 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 a screening test for (1) cystic fibrosis, and (2) critical congenital heart disease. Such screening tests shall be administered as soon after birth as is medically appropriate.

(e) The clinical laboratory that completes the testing for cystic fibrosis shall report the number of newborn infants screened and the results of such testing, not less than annually, to the Department of Public Health into the newborn screening system pursuant to section 19a-53. The administrative officer or other person in charge of each institution caring for newborn infants who performs the testing for critical congenital heart disease shall enter the results of such test into the newborn screening system pursuant to section 19a-53.

(f) 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.

(February, 1965, P.A. 108, S. 1, 2; P.A. 77-614, S. 323, 610; P.A. 78-193, S. 1, 2, 4; P.A. 92-227, S. 1, 2; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; June 18 Sp. Sess. P.A. 97-8, S. 26; June Sp. Sess. P.A. 99-2, S. 30; P.A. 02-113, S. 1; June 30 Sp. Sess. P.A. 03-3, S. 5; P.A. 05-272, S. 43; P.A. 06-196, S. 210; P.A. 09-20, S. 1; June Sp. Sess. P.A. 09-3, S. 167; P.A. 11-48, S. 38; P.A. 12-13, S. 1; P.A. 13-242, S. 1; P.A. 15-10, S. 1; 15-242, S. 49; June Sp. Sess. P.A. 15-5, S. 346, 506; P.A. 16-66, S. 22; P.A. 17-146, S. 14; P.A. 19-117, S. 148; 19-176, S. 1; P.A. 21-121, S. 75; P.A. 23-204, S. 191.)

History: P.A. 77-614 replaced department of health with department of health services, effective January 1, 1979; P.A. 78-193 included tests for hypothyroidism and galactosemia and transferred regulation power from department to commissioner; Sec. 19-21b transferred to Sec. 19a-55 in 1983; P.A. 92-227 amended Subsec. (a) to add sickle cell disease, maple syrup urine disease, homocystinuria and biotinidase deficiency to list of diseases for infant testing and to detail responsibilities of the commissioner in administering the program; P.A. 93-381 replaced department of health services with department of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; June 18 Sp. Sess. P.A. 97-8 added congenital adrenal hyperplasia to the list of diseases tested for; June Sp. Sess. P.A. 99-2 amended Subsec. (a) by replacing “infants twenty-eight days or less of age” with “newborn infants”, adding HIV-related test, adding provision that tests be administered as soon after birth as is medically appropriate and that test may be omitted if done under other statutes, and adding “consistent with any applicable confidentiality requirements” in Subdiv. (2); P.A. 02-113 amended Subsec. (a) to add requirement for testing of “other metabolic diseases”, to add a minimum fee requirement of $28, and to add requirement that on or before January 1, 2003, the regulations shall include testing for amino acid disorders, organic acid disorders and fatty acid oxidation disorders; June 30 Sp. Sess. P.A. 03-3 amended Subsec. (a) by changing date for regulations requiring testing for certain disorders from January 1, 2003, to January 1, 2004, effective August 20, 2003; P.A. 05-272 amended Subsec. (a) by removing requirement that newborn screening regulations specify abnormal conditions to be tested for and manner of recording and reporting results and, instead, requiring Commissioner of Public Health to publish list of all abnormal conditions for which department screens newborns under newborn screening program, effective July 13, 2005; P.A. 06-196 made a technical change in Subsec. (a), effective June 7, 2006; P.A. 09-20 added new Subsec. (b) requiring that newborn infants be administered screening test for cystic fibrosis and redesignated existing Subsec. (b) as Subsec. (c); June Sp. Sess. P.A. 09-3 amended Subsec. (a) to increase fee from $28 to $56; P.A. 11-48 repositioned provision re adoption of regulations from Subsec. (a) to Subsec. (c) and amended Subsec. (b) by requiring screening test for severe combined immunodeficiency disease and by making a technical change; P.A. 12-13 amended Subsec. (b) by designating existing provisions re screening tests for cystic fibrosis and severe combined immunodeficiency disease as Subdivs. (1) and (2) and adding Subdiv. (3) re screening test for critical congenital heart disease; P.A. 13-242 added new Subsec. (c) re test for adrenoleukodystrophy and redesignated existing Subsec. (c) as Subsec. (d); P.A. 15-10 amended Subsec. (b) by designating existing provisions re screening tests to be administered as Subdiv. (1), redesignating existing Subdivs. (1) to (3) as Subparas. (A) to (C) and adding new Subdiv. (2) re screening test for infant who fails a hearing screening, added new Subsec. (d) re reporting cases of cytomegalovirus and redesignated existing Subsec. (d) as Subsec. (e), effective July 1, 2015; P.A. 15-242 amended Subsec. (d) by making a technical change, effective June 30, 2015; June Sp. Sess. P.A. 15-5 amended Subsec. (a) to replace “fifty-six” with “ninety-eight” re minimum fees, effective July 1, 2015, and deleted former Subsec. (c) re development and validation of reliable methodology for screening for adrenoleukodystrophy and added new Subsec. (c) re agreement with New York State Department of Health to screen for adrenoleukodystrophy, effective October 1, 2015; P.A. 16-66 amended Subsec. (a) to add reference to severe combined immunodeficiency disease and adrenoleukodystrophy, amended Subsec. (b)(1) to delete former Subpara. (B) re severe combined immunodeficiency disease and redesignate existing Subpara. (C) re critical congenital heart disease as Subpara. (B), deleted former Subsec. (c) re screening test for adrenoleukodystrophy and redesignated existing Subsecs. (d) and (e) as Subsecs. (c) and (d); P.A. 17-146 amended Subsec. (b) by adding provision re entering results of testing for critical congenital heart disease into newborn screening system; P.A. 19-117 amended Subsec. (a) by adding provision re screening for any other disorder included on recommended uniform screening panel subject to approval by the Secretary of the Office of Policy and Management and made technical changes; P.A. 19-176 amended Subsec. (b)(1) by adding Subpara. (C) re spinal muscular atrophy and making technical changes; P.A. 21-121 substantially revised section including by adding provision re approval of fees by Secretary of the Office of Policy and Management in Subsec. (a)(3), moving existing provisions re specific screenings from Subsec. (a) to new Subsec. (b) and amended same by adding provisions re screenings performed using bloodspot specimens and re timeframes for specimen collection and notification, designating existing provisions in Subsec. (a) re commissioner to publish list of abnormal conditions as new Subsec. (c) and amending same to add additional amino acid disorders, redesignating existing Subsec. (b) as new Subsec. (d) and amending same to delete Subdiv. (1)(C) re spinal muscular atrophy and provisions re funding for cytomegalovirus screening test and reporting re congenital heart disease in Subdiv. (2), adding Subsec. (e)(1) re reporting requirements, redesignating existing Subsec. (c) as Subsec. (e)(2) and amending same to add provisions re newborn screening system and patient's insurance status or source of payment, redesignating existing Subsec. (d) as Subsec. (f) and making technical and conforming changes, effective July 6, 2021; P.A. 23-204 amended Subsec. (c) by designating existing provisions as Subdiv. (1) and adding Subdiv. (2) re cytomegalovirus, Subsec. (d) by deleting former Subdiv. (2) re cytomegalovirus and making technical changes, and Subsec. (e) by deleting former Subdiv. (2) re cytomegalovirus and Subdiv. (1) designator, effective June 12, 2023.

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Sec. 19a-59j. Infant mortality review program. Confidentiality of information. (a) As used in this section and section 19a-59k, “infant death” means the death of a child that occurs between birth and one year of age.

(b) There is established, within the Department of Public Health, an infant mortality review program. The purpose of the program shall be to review medical records and other relevant data related to infant deaths, including, but not limited to, information collected from death and birth records, and medical records from health care providers and health care facilities for the purposes of making recommendations to reduce health care disparities and identify gaps in or problems with the delivery of care or services to reduce infant deaths.

(c) All health care providers, health care facilities and pharmacies shall provide the Commissioner of Public Health, or the commissioner's designee, with access to all medical and other records associated with an infant death case under review by the program, including, but not limited to, prenatal care records, upon the request of the commissioner.

(d) A person who completes a death certificate pursuant to section 7-62b or 19a-409 for an infant death shall report such death to the department in a form and manner prescribed by the commissioner.

(e) Notwithstanding any provision of the general statutes, the commissioner shall notify the child fatality review panel, established pursuant to section 46a-13l, of an infant death if, pursuant to a review performed by the infant mortality review program, the commissioner determines that such infant death occurred in out-of-home care or was due to unexpected or unexplained causes.

(f) All information obtained by the commissioner, or the commissioner's designee, for the infant mortality review program shall be confidential pursuant to section 19a-25.

(g) Notwithstanding any provision of the general statutes, the commissioner, or the commissioner's designee may provide the infant mortality review committee, established pursuant to section 19a-59k, with information as is necessary, in the commissioner's discretion, for the committee to make recommendations regarding the prevention of infant deaths.

(h) The provisions of this section and section 19a-59k shall not be construed to limit or alter the authority of the Office of the Child Advocate or the child fatality review panel, established pursuant to section 46a-13l, to investigate or make recommendations regarding a child's death pursuant to the provisions of said section.

(P.A. 23-147, S. 10.)

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Sec. 19a-59k. Infant mortality review committee. (a) There is established an infant mortality review committee within the department to conduct a comprehensive, multidisciplinary review of infant deaths for purposes of reducing health care disparities, identifying factors associated with infant deaths and making recommendations to reduce infant deaths.

(b) The cochairpersons of the infant mortality review committee shall be the Commissioner of Public Health, or the commissioner's designee, and a representative designated by the Connecticut chapter of the American Academy of Pediatrics. The cochairpersons shall convene a meeting of the infant mortality review committee upon the request of the Commissioner of Public Health.

(c) The infant mortality review committee may include, but need not be limited to, any of the following members, as needed, depending on the infant death case being reviewed:

(1) A physician licensed pursuant to chapter 370, who specializes in obstetrics and gynecology, designated by the Connecticut Chapter of the American College of Obstetrics and Gynecology;

(2) A community health worker, designated by the Commission on Women, Children, Seniors, Equity and Opportunity;

(3) A pediatric nurse licensed pursuant to chapter 378, designated by the Connecticut Nurses Association;

(4) A clinical social worker licensed pursuant to chapter 383b, designated by the Connecticut Chapter of the National Association of Social Workers;

(5) The Chief Medical Examiner, or the Chief Medical Examiner's designee;

(6) A member of the Connecticut Hospital Association representing a pediatric facility;

(7) A representative of The University of Connecticut-sponsored Health Disparities Institute;

(8) A physician licensed pursuant to chapter 370, who practices neonatology, designated by the Connecticut Medical Society;

(9) A physician assistant licensed pursuant to chapter 370 or advanced practice registered nurse licensed pursuant to chapter 378, designated by an association representing physician assistants or advanced practice registered nurses in the state;

(10) The Child Advocate, or the Child Advocate's designee;

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

(12) The Commissioner of Children and Families, or the commissioner's designee;

(13) The Commissioner of Early Childhood, or the commissioner's designee;

(14) The Commissioner of Mental Health and Addiction Services, or the commissioner's designee; and

(15) Any additional member the cochairpersons determine would be beneficial to serve as a member of the committee.

(d) For any infant mortality review, the committee may consult with relevant experts to evaluate the information and findings obtained from the department pursuant to section 19a-59j and make recommendations regarding the prevention of infant deaths.

(e) The infant mortality review committee shall include available infant death reports and recommendations produced by the child fatality review panel, established pursuant to section 46a-13l, in its review of infant deaths for the purposes of making recommendations to reduce health care disparities and identify gaps in or problems with the delivery of care or services to reduce infant deaths.

(f) Not later than ninety days after completing an infant mortality review, the committee shall, in consultation with the Office of the Child Advocate, report to the Commissioner of Public Health the recommendations and findings of the committee in a manner that complies with section 19a-25.

(g) All information provided by the department to the infant mortality review committee or provided to any expert consulted by the committee shall be subject to the provisions of section 19a-25.

(P.A. 23-147, S. 11.)

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Sec. 19a-59l. Midwifery working group. Responsibilities. Appointments. Annual report. (a) As used in this section:

(1) “Certified midwife” means any individual who completes a graduate degree in midwifery and passes a national certification examination administered by the American Midwifery Certification Board to receive the professional designation of certified midwife;

(2) “Community birth” means a planned home birth or a birth occurring at a birth center;

(3) “Direct entry midwife” means any individual trained in planned out-of-hospital births other than a nurse-midwife, which may include certified midwives, certified professional midwives, community midwives and traditional midwives; and

(4) “Licensed nurse-midwife” means any individual licensed as a nurse-midwife pursuant to chapter 377.

(b) The Commissioner of Public Health shall establish a midwifery working group. The working group shall study and make recommendations concerning the advancement of choices in care for community birth and the role of direct entry midwives in addressing maternal and infant health disparities. Such study shall include, but need not be limited to:

(1) Improvements in birthing care quality and safety, including improvements addressing racial disparities in maternal and infant health outcomes;

(2) Regulation, licensure or certification of direct entry midwives not otherwise licensed to practice midwifery in the state;

(3) Regulation, licensure or certification of certified midwives not otherwise licensed to practice midwifery in the state; and

(4) Advancements of interprofessional coordination of birthing care, including community birth.

(c) The Commissioner of Public Health shall appoint members of the working group. Such members shall include, but need not be limited to, the commissioner's designee, at least six direct-entry midwives practicing in the state, a certified nurse-midwife with experience working with direct entry midwives, a certified midwife representing an entity that certifies midwives, a doula serving communities of color, a representative of families or a community-based organization with an interest in maternity care, a representative of a community organization furthering health equity, representatives of associated maternity care professions, a representative of the state hospital association and a representative of the Department of Social Services.

(d) Not later than February 1, 2024, and annually thereafter, the midwifery working group shall report to the Commissioner of Public Health and, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to public health on its findings and recommendations.

(e) The midwifery working group shall select to renew or disband the group on an annual basis in a manner determined by the commissioner or the commissioner's designee.

(P.A. 23-147, S. 15.)

History: P.A. 23-147 effective July 1, 2023.

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Sec. 19a-77. “Child care services” defined. Exclusions. Additional license. (a) As used in this section and sections 19a-77a to 19a-80, inclusive, and sections 19a-82 to 19a-87a, inclusive, “child care services” includes:

(1) A “child care center” which offers or provides a program of supplementary care to more than twelve related or unrelated children outside their own homes on a regular basis;

(2) A “group child care home” which offers or provides a program of supplementary care (A) to not less than seven or more than twelve related or unrelated children on a regular basis, or (B) that meets the definition of a family child care home except that it operates in a facility other than a private family home;

(3) A “family child care home” which consists of a private family home providing care (A) for (i) not more than six children, including the provider's own children not in school full time, without the presence or assistance of an assistant or substitute staff member approved by the Commissioner of Early Childhood, pursuant to section 19a-87b, present and assisting the provider, or (ii) not more than nine children, including the provider's own children, with the presence and assistance of such approved assistant or substitute staff member, and (B) for not less than three or more than twelve hours during a twenty-four-hour period and where care is given on a regularly recurring basis except that care may be provided in excess of twelve hours but not more than seventy-two consecutive hours to accommodate a need for extended care or intermittent short-term overnight care. During the regular school year, for providers described in subparagraph (A)(i) of this subdivision, a maximum of three additional children who are in school full time, including such provider's own children, shall be permitted, except that if such provider has more than three children who are such provider's own children and in school full time, all of such provider's own children shall be permitted. During the summer months when regular school is not in session, for providers described in subparagraph (A)(i) of this subdivision, a maximum of three additional children who are otherwise enrolled in school full time shall be permitted if there is such an approved assistant or substitute staff member present and assisting such provider, except that (i) if such provider has more than three such additional children who are such provider's own children, all of such provider's own children shall be permitted, and (ii) such approved assistant or substitute staff member shall not be required if all of such additional children are such provider's own children;

(4) “Night care” means the care provided for one or more hours between the hours of 10:00 p.m. and 5:00 a.m.; and

(5) “Year-round” program means a program open at least fifty weeks per year.

(b) For licensing requirement purposes, child care services shall not include such services which are:

(1) (A) Administered by a public school system, or (B) administered by a municipal agency or department;

(2) Administered by a private school which is in compliance with section 10-188 and is approved by the State Board of Education or is accredited by an accrediting agency recognized by the State Board of Education, provided the provision of such child care services by the private school is only to those children whose ages are covered under such approval or accreditation;

(3) Classes in music, dance, drama and art that are no longer than two hours in length; classes that teach a single skill that are no longer than two hours in length; library programs that are no longer than two hours in length; scouting; programs that offer exclusively sports activities; rehearsals; academic tutoring programs; or programs exclusively for children thirteen years of age or older;

(4) Informal arrangements among neighbors and formal or informal arrangements among relatives in their own homes, provided the relative is limited to any of the following degrees of kinship by blood, marriage or court order to the child being cared for: Grandparent, great-grandparent, sibling, aunt or uncle;

(5) Supplementary child care operations for educational or recreational purposes and the child receives such care infrequently where the parents are on the premises;

(6) Supplementary child care operations in retail establishments where the parents remain in the same store as the child for retail shopping, provided the drop-in supplementary child-care operation does not charge a fee and does not refer to itself as a child care center;

(7) Administered by a nationally chartered boys' and girls' club that are exclusively for school-age children;

(8) Religious educational activities administered by a religious institution exclusively for children whose parents or legal guardians are members of such religious institution;

(9) Administered by Solar Youth, Inc., a New Haven-based nonprofit youth development and environmental education organization;

(10) Programs administered by organizations under contract with the Department of Social Services pursuant to section 17b-851a that promote the reduction of teenage pregnancy through the provision of services to persons who are ten to nineteen years of age, inclusive;

(11) Administered by the Cardinal Shehan Center, a Bridgeport-based nonprofit organization that is exclusively for school-age children;

(12) Administered by Organized Parents Make a Difference, Inc., a Hartford-based nonprofit organization that is exclusively for school-age children;

(13) Administered by Leadership, Education and Athletics in Partnership, Inc., a New Haven-based nonprofit youth development organization;

(14) Programs that exclusively provide care for children of members of the United States Coast Guard or any branch of the military under the United States Department of Defense and that are (A) administered by the federal government or on federal property, or (B) administered by a person certified as a family child care provider by the United States Coast Guard or a branch of the military under the United States Department of Defense; or

(15) Administered by Police Athletic League of Stamford, Inc., a Stamford-based nonprofit youth activities organization.

(c) Any entity or organization that provides services or a program described in subsection (b) of this section shall inform the parents and legal guardians of any children receiving such services or enrolled in such programs that such entity or organization is not licensed by the Office of Early Childhood to provide such services or offer such program.

(d) No registrant or licensee of any child care services as defined in subsection (a) of this section shall be issued an additional registration or license to provide any such services at the same facility.

(e) When a licensee has vacated premises approved by the office for the provision of child care services and the landlord of such licensee establishes to the satisfaction of the office that such licensee has no legal right or interest to such approved premises, the office may make a determination with respect to an application for a new license for the provision of child care services at such premises.

(1967, P.A. 696, S. 1; 1971, P.A. 276, S. 1; P.A. 77-157, S. 1, 11; P.A. 82-35, S. 1, 2; P.A. 83-56; P.A. 85-613, S. 39, 154; P.A. 86-417, S. 10, 15; P.A. 87-131; P.A. 90-298, S. 1; P.A. 93-20, S. 1; 93-175; P.A. 95-360, S. 21, 30, 32; P.A. 97-259, S. 32, 41; P.A. 98-71, S. 1, 3; 98-252, S. 56; P.A. 00-135, S. 2, 21; P.A. 03-252, S. 22; June 30 Sp. Sess. P.A. 03-3, S. 29; P.A. 05-272, S. 40; P.A. 07-129, S. 1; 07-252, S. 87; P.A. 08-184, S. 25; P.A. 09-232, S. 42, 103; P.A. 10-117, S. 75; P.A. 11-193, S. 1; 11-242, S. 14; P.A. 14-38, S. 2; 14-39, S. 48; P.A. 15-227, S. 20, 25; P.A. 16-100, S. 2; P.A. 18-169, S. 1; 18-172, S. 4; P.A. 19-122, S. 1; P.A. 22-81, S. 7; P.A. 23-29, S. 1; 23-204, S. 187.)

History: 1971 act excluded from consideration as child day care center, facilities which are an integral part of a public or private school in compliance with Sec. 10-188, previously exclusion was for facilities forming an integral part of “the school system”; P.A. 77-157 redefined “child day care center” to remove reference to excluded facilities and to require enrollment of “more than twelve” children rather than of “five or more”, defined “group day care home” and “family day care home” in new Subsecs. (b) and (c) and grouped all definitions as “child day care services” and added Subsec. (d) re services not considered child day care services; P.A. 82-35 amended Subsec. (a) to include “related” children in the description of a child day care center, amended Subsec. (b) to change the number of children cared for in a group day care home from not less than five to not less than seven, amended Subsec. (c) to allow “six children including the provider's own children not in school full time” to be cared for in a family day care home where previously the limit had been “four children not related to the provider”, and added Subdiv. (4) on drop in supplementary child care operations to Subsec. (d); Sec. 19-43b transferred to Sec. 19a-77 in 1983; P.A. 83-56 added Subsec. (e) prohibiting the issuance of an additional license to provide services at the same facility; P.A. 85-613 made technical changes; P.A. 86-417 added references to registration in Subsecs. (d) and (e); P.A. 87-131 reordered the subsections, combining Subsecs. (a), (b) and (c) as Subsec. (a) and relettering Subsecs. (d) and (e) accordingly and added language in Subsec. (a) on the maximum number of children in school full time allowed during the school year; P.A. 90-298 excluded library programs from registration and licensing requirements in Subsec. (b); P.A. 93-20 amended definition of “family day care home” in Subsec. (a) to allow extended care or intermittent short-term overnight care; P.A. 93-175 amended Subsec. (b) by removing reference to private schools in Subdiv. (1) and inserting as new Subdiv. (2) a provision requiring private schools to be approved or accredited to remain exempt from licensing and registration requirements and renumbered remaining Subdivs. accordingly; P.A. 95-360 substituted Sec. 19a-82 for Sec. 19a-81 in Subsec. (a), effective July 13, 1995, and amended Subsec. (b) by providing the definition of “relative” for purposes of Subdiv. (4); P.A. 97-259 added definitions of “night care” and “year-round” in Subsec. (a), effective July 1, 1997; P.A. 98-71 amended Subsec. (b) by adding Subdiv. (6) re retail establishments and made technical changes by moving definition of “relative” to Subdiv. (4), effective May 19, 1998; P.A. 98-252 amended Subsec. (b) to add creative art studios in Subdiv. (3); P.A. 00-135 amended Subsec. (b)(1) by designating existing provisions as Subpara. (A) and adding Subpara. (B) re services administered by a municipal agency or department and located in a public school building, effective May 26, 2000; P.A. 03-252 amended Subsec. (b) by adding Subdiv. (7) re activities administered by religious institution, effective July 9, 2003; June 30 Sp. Sess. P.A. 03-3 amended Subsec. (b) by deleting reference to “registration” requirement purposes and deleting requirement in Subdiv. (1) that children be “students enrolled in that school”, effective August 20, 2003; P.A. 05-272 amended Subsec. (b) by making technical changes and removing reference to “boys' and girls' clubs” in Subdiv. (3), adding new Subdiv. (7) to exempt drop-in programs administered by a nationally chartered boys' and girls' club from day care licensing requirements and redesignating existing Subdiv. (7) as Subdiv. (8), effective July 13, 2005; P.A. 07-129 amended Subsec. (a)(2) by redefining “group day care home” to include programs of supplementary care that meet definition of a family day care home except that they operate in a facility other than a private family home, amended Subsec. (b)(3) by modifying list of services exempted from child day care licensing requirements and made technical changes; P.A. 07-252 amended Subsec. (b)(3) to delete 4-H from list of exempted activities and to revise exemption re sports activities; P.A. 08-184 made technical changes in Subsec. (a)(2) and (3); P.A. 09-232 added Subsec. (b)(9) excluding Solar Youth, Inc. from licensing requirements, effective July 1, 2009, and added Subsec. (d) re application for new license at approved premises when former licensee has vacated such premises, effective July 8, 2009; P.A. 10-117 added Subsec. (b)(10) re excluding for licensing requirement purposes programs administered by organizations under contract with Department of Social Services that promote reduction of teenage pregnancy, effective June 8, 2010; P.A. 11-193 added Subsec. (b)(11) excluding Cardinal Shehan Center from licensing requirements, effective July 1, 2011; P.A. 11-242 amended Subsec. (b)(4) by excluding formal arrangements among relatives from child day care licensing requirements and amended Subsec. (b)(6) by deleting reference to repealed Sec. 19a-77a and by substituting “parents remain in the same store as the child” for “parents are on the premises”; P.A. 14-38 amended Subsec. (b)(1) by deleting “and located in a public school building”, effective July 1, 2014; P.A. 14-39 replaced references to Department of Public Health with references to Office of Early Childhood, effective July 1, 2014; P.A. 15-227 amended Subsec. (a) by making definitions applicable to Sec. 19a-87a, replacing “child day care services” with “child care services”, “child day care center” with “child care center”, “group day care home” with “group child care home” and “family day care home” with “family child care home”, and making technical changes, effective July 1, 2015; pursuant to P.A. 15-227, “child day care services” and “child day care center” were changed editorially by the Revisors to “child care services” and “child care center”, respectively, in Subsecs. (b) to (d), effective July 1, 2015; P.A. 16-100 amended Subsec. (b) by replacing “Drop-in supplementary” with “Supplementary” in Subdivs. (5) and (6), replacing “Drop-in programs administered” with “Administered” and adding “that are exclusively for school-age children” in Subdiv. (7) and deleting provisions re programs to inform parents and guardians that such programs are not licensed by Office of Early Childhood in Subdivs. (9) and (11), added new Subsec. (c) re certain programs to inform parents and guardians that such programs are not licensed by Office of Early Childhood, and redesignated existing Subsecs. (c) and (d) as Subsecs. (d) and (e), effective July 1, 2016; P.A. 18-169 added Subsec. (b)(12) re Organized Parents Make a Difference, Inc., effective June 14, 2018; P.A. 18-172 amended Subsec. (a)(3) by redefining “family child care home” to include provision re maximum number of additional children during summer months when school is not in session, and amended Subsec. (b) by adding provision re child care services provided by private school only to children covered under approval or accreditation in Subdiv. (2), and substantially revising provision re degrees of kinship, including adding reference to court order in Subdiv. (4), effective July 1, 2018; P.A. 19-122 added Subsec. (b)(13) re Leadership, Education and Athletics in Partnership, Inc., effective July 12, 2019; P.A. 22-81 amended Subsec. (a)(3) by redefining “family child care home”, effective July 1, 2022; P.A. 23-29 amended Subsec. (b) by adding Subdiv. (14) re programs that exclusively provide care for children of military members, effective June 12, 2023; P.A. 23-204 added Subsec. (b)(14), codified by the Revisors as Subsec. (b)(15), re Police Athletic League of Stamford, Inc., effective June 12, 2023.

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Sec. 19a-80. (Formerly Sec. 19-43e). License required for child care centers and group child care homes. Fees. Comprehensive background checks. Notification of changes in regulations. (a) No person, group of persons, association, organization, corporation, institution or agency, public or private, shall maintain a child care center or group child care home without a license issued in accordance with this section and sections 19a-77 to 19a-79a, inclusive, and 19a-82 to 19a-87a, inclusive. Applications for such license shall be made to the Commissioner of Early Childhood on forms provided by the commissioner and shall contain the information required by regulations adopted under said sections. The forms shall contain a notice that false statements made therein are punishable in accordance with section 53a-157b.

(b) (1) Upon receipt of an application for a license, the commissioner shall issue such license if, upon inspection and investigation, said commissioner finds that the applicant, the facilities and the program meet the health, educational and social needs of children likely to attend the child care center or group child care home and comply with requirements established by regulations adopted under this section and sections 19a-77 to 19a-79a, inclusive, and sections 19a-82 to 19a-87a, inclusive. Any such inspection under this subsection of a group child care home located in a residence shall include an inspection for evident sources of lead poisoning and shall provide for chemical analysis of any paint chips found on such premises. The commissioner shall offer an expedited application review process for an application submitted by a municipal agency or department. A currently licensed person or entity, as described in subsection (a) of this section, seeking a change of operator, ownership or location shall file a new license application, except such person or entity may request the commissioner to waive the requirement that a new license application be filed. The commissioner may grant or deny such request. Each license shall be for a term of four years, shall be nontransferable, and may be renewed upon receipt by the commissioner of a renewal application and accompanying licensure fee. The commissioner may suspend or revoke such license after notice and an opportunity for a hearing as provided in section 19a-84 for violation of the regulations adopted under this section and sections 19a-77 to 19a-79a, inclusive, and sections 19a-82 to 19a-87a, inclusive. In the case of an application for renewal of a license that has expired, the commissioner may renew such expired license within thirty days of the date of such expiration upon receipt of a renewal application and accompanying licensure fee.

(2) The commissioner shall collect from the licensee of a child care center a fee of five hundred dollars prior to issuing or renewing a license for a term of four years. The commissioner shall collect from the licensee of a group child care home a fee of two hundred fifty dollars prior to issuing or renewing a license for a term of four years. The commissioner shall require only one license for a child care center operated in two or more buildings, provided the same licensee provides child care services in each building and the buildings are joined together by a contiguous playground that is part of the licensed space.

(3) The commissioner, or the commissioner's designee, shall make an unannounced visit, inspection or investigation of each licensed child care center and group child care home at least once each year. At least once every two years, the local health director, or the local health director's designee, shall inspect each licensed child care center and group child care home.

(4) A municipality may not subject the operation of a licensed group child care home located in a residence to any conditions, other than those imposed by the commissioner pursuant to this subsection, if the group child care home complies with all codes and ordinances applicable to single and multifamily dwellings.

(c) The commissioner shall require each prospective employee of a child care center or group child care home for a position that requires the provision of care to a child or involves unsupervised access to any child in such child care center or group child care home, to submit to comprehensive background checks, including state and national criminal history records checks. The criminal history records checks required pursuant to this subsection shall be conducted in accordance with section 29-17a. The commissioner shall also request a check of the state child abuse registry established pursuant to section 17a-101k. The Commissioner of Early Childhood shall notify each licensee of the provisions of this subsection. No such prospective employee shall begin working in such child care center or group child care home until the provisions of 45 CFR 98.43(d)(4), as amended from time to time, have been satisfied.

(d) The commissioner shall inform each licensee, by way of a plain language summary provided not later than sixty days after the regulation's effective date, of new or changed regulations adopted under this section and sections 19a-77 to 19a-79a, inclusive, or sections 19a-82 to 19a-87a, inclusive, with which a licensee must comply.

(1967, P.A. 696, S. 2, 3; P.A. 77-157, S. 4, 11; 77-614, S. 323, 610; P.A. 82-256, S. 2; P.A. 85-613, S. 42, 154; May Sp. Sess. P.A. 92-6, S. 7, 117; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; 95-360, S. 9, 32; P.A. 97-259, S. 33, 41; P.A. 98-250, S. 14, 39; June Sp. Sess. P.A. 99-2, S. 69; P.A. 01-175, S. 15, 32; P.A. 03-243, S. 11; P.A. 05-207, S. 9; P.A. 07-22, S. 1; 07-129, S. 2; P.A. 09-232, S. 104; June Sp. Sess. P.A. 09-3, S. 168; P.A. 10-117, S. 30; P.A. 11-97, S. 1; 11-242, S. 16; P.A. 14-39, S. 50; P.A. 15-143, S. 5; 15-227, S. 21, 25; P.A. 16-100, S. 1; 16-163, S. 35; June Sp. Sess. P.A. 17-2, S. 174; P.A. 18-172, S. 3; P.A. 21-172, S. 7; P.A. 23-142, S. 4.)

History: P.A. 77-157 added references to group day care homes; P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; P.A. 82-256 required that application forms contain a notice that false statements are punishable in accordance with Sec. 53a-157 and increased the license fee for day care centers from $25 to $100 and the fee for group day care homes from $25 to $50; Sec. 19-43e transferred to Sec. 19a-80 in 1983; P.A. 85-613 made technical changes; May Sp. Sess. P.A. 92-6 amended Subsec. (b) to raise fee for day care center two-year term license or renewal from $100 to $200, six-month license or renewal from $15 to $50, and for group day care home two-year term license or renewal from $50 to $100 and a six-month license or renewal from $15 to $30; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 95-360 allowed license revocation or suspension after “an opportunity for” a hearing rather than requiring a hearing and substituted Sec. 19a-82 for Sec. 19a-81, effective July 13, 1995; P.A. 97-259 added Subsec. (c) re criminal records checks and state child abuse registry checks, effective July 1, 1997; P.A. 98-250 added new Subsec. (d) re plain language summary, effective July 1, 1998; June Sp. Sess. P.A. 99-2 amended Subsec. (c) by changing “criminal records check” and “criminal history records check” to “fingerprint criminal records check” and “fingerprint criminal history records check”; P.A. 01-175 amended Subsec. (c) by replacing language re fingerprint criminal records checks as a permissive request with language re mandatory state and national criminal history records checks pursuant to Sec. 29-17a, deleted language re fee and made technical changes, effective July 1, 2001; P.A. 03-243 added “for perpetrator information” in Subsec. (c); P.A. 05-207 amended Subsec. (c) to delete requirement that commissioner check state child abuse registry for perpetrator information; P.A. 07-22 made technical changes in Subsecs. (a) and (b) and added provision in Subsec. (b) specifying licensing requirements for child day care centers operated by the same licensee in 2 or more buildings joined together by a contiguous playground, effective May 9, 2007; P.A. 07-129 amended Subsec. (b) by adding Subdiv. designators (1) to (3), disallowing issuance of temporary licenses, extending license term from 2 to 4 years on and after October 1, 2008, increasing licensing fee from $200 to $400 on and after October 1, 2008, and making technical changes; P.A. 09-232 amended Subsec. (b)(1) by adding provision requiring commissioner to offer expedited review process for application submitted by municipal agency or department, effective July 8, 2009; June Sp. Sess. P.A. 09-3 amended Subsec. (b)(3) to increase license fees; P.A. 10-117 amended Subsec. (b)(1) by substituting “nontransferable” for “transferable” re licenses, effective June 8, 2010; P.A. 11-97 amended Subsecs. (a), (b) and (d) by substituting “19a-87a” for “19a-87”, amended Subsec. (b)(1) by adding provision re commissioner's discretion to determine whether change of operator, ownership or location requires filing of a new license application by license holder and by making technical changes, deleted former Subsec. (b)(2) re license fees prior to October 1, 2008, redesignated existing Subsec. (b)(3) as Subsec. (b)(2) and made technical changes in same; P.A. 11-242 amended Subsec. (b)(1) by adding provision re renewal of license upon receipt of renewal application and accompanying license fee and by making technical changes, deleted former Subsec. (b)(2) re license fees prior to October 1, 2008, redesignated existing Subsec. (b)(3) as Subsec. (b)(2) and amended same by replacing “for each license issued or renewed” with “prior to issuing or renewing a license” and making technical changes; P.A. 14-39 replaced references to Commissioner and Department of Public Health with references to Commissioner and Office of Early Childhood and amended Subsec. (b) by adding Subdiv. (3) re unannounced visit, inspection or investigation, effective July 1, 2014; P.A. 15-143 amended Subsec. (c) by deleting reference to Sec. 10-16s and replacing “commissioner” with “Commissioner of Early Childhood”, effective June 30, 2015; P.A. 15-227 amended Subsec. (b)(1) by replacing “child day care center” with “child care center” and “group day care home” with “group child care home”, adding provision re renewal of expired license, and making technical changes, effective July 1, 2015; pursuant to P.A. 15-227, “child day care center”, “group day care home” and “child day care services” were changed editorially by the Revisors to “child care center”, “group child care home” and “child care services”, respectively, in Subsecs. (a), (b)(2) and (3), and (c), effective July 1, 2015; P.A. 16-100 amended Subsec. (b)(1) by adding provision re currently licensed person or entity seeking change of operator, ownership or location to file new license application and making a conforming change; P.A. 16-163 amended Subsec. (b)(2) by replacing “day care center” with “child care center”, effective June 9, 2016; June Sp. Sess. P.A. 17-2 amended Subsec. (c) by adding “comprehensive background checks, including” and adding provision re prospective employee not to have unsupervised access to children until comprehensive background check is completed and commissioner permits prospective employee to work, effective October 31, 2017; P.A. 18-172 amended Subsec. (b)(1) by deleting “if such person or entity submits such request prior to the change of operator, ownership or location” re request for commissioner to waive requirement that new license application be filed, effective July 1, 2018; P.A. 21-172 amended Subsec. (c) by deleting “, within available appropriations,”, adding provision re position involving unsupervised access to any child in child care center or group child care home, deleting provision re Department of Social Services agreeing to transfer funds to office for criminal history records checks, and replacing provision re prospective employee not to have unsupervised access to children until comprehensive background check is completed and commissioner permits prospective employee to work with provision re prospective employee not to begin working until provisions of 45 CFR 98.43(d)(4) are satisfied; P.A. 23-142 amended Subsec. (a) to replace reference to Sec. 19a-80 with 19a-79a, amended Subsec. (b)(1) to add provision re inspection for evident sources of lead poisoning in group child care home located in a residence, added Subsec. (b)(4) re prohibition on municipality imposing additional conditions on licensed group child care home located in a residence, and made technical and conforming changes.

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Sec. 19a-87b. (Formerly Sec. 17-585(b)–(d)). License required for family child care homes. Approval required to act as assistant or substitute staff member; provision of child care services by substitute staff members. Comprehensive background checks. Fees. Regulations; waivers. License to operate family child care home in facility that is not private family home. (a) No person, group of persons, association, organization, corporation, institution or agency, public or private, shall maintain a family child care home, as described in section 19a-77, without a license issued by the Commissioner of Early Childhood. Licensure forms shall be obtained from the Office of Early Childhood. Applications for licensure shall be made to the commissioner on forms provided by the office and shall contain the information required by regulations adopted under this section. The licensure and application forms shall contain a notice that false statements made therein are punishable in accordance with section 53a-157b. Applicants shall state, in writing, that they are in compliance with the regulations adopted by the commissioner pursuant to subsection (f) of this section. Before a family child care home license is granted, the office shall make an inquiry and investigation which shall include a visit and inspection of the premises for which the license is requested. Any inspection conducted by the office shall include an inspection for evident sources of lead poisoning. The office shall provide for a chemical analysis of any paint chips found on such premises. Neither the commissioner nor the commissioner's designee shall require an annual inspection for homes seeking license renewal or for licensed homes, except that the commissioner or the commissioner's designee shall make an unannounced visit, inspection or investigation of each licensed family child care home at least once every year. A licensed family child care home shall not be subject to any conditions on the operation of such home by local officials, other than those imposed by the office pursuant to this subsection, if the home complies with all codes and ordinances applicable to single and multifamily dwellings.

(b) (1) No person shall act as an assistant or substitute staff member to a person or entity maintaining a family child care home, as defined in section 19a-77, without an approval issued by the commissioner. Any person seeking to act as an assistant or substitute staff member in a family child care home shall submit an application for such approval to the office. Applications for approval shall: (A) Be made to the commissioner on forms provided by the office, (B) contain the information required by regulations adopted under this section, and (C) be accompanied by a fee of fifteen dollars. The approval application forms shall contain a notice that false statements made in such form are punishable in accordance with section 53a-157b.

(2) A licensee of a family child care home who is attending a medical appointment, receiving medical treatment or completing education or training may use a substitute staff member who has been approved pursuant to this subsection to provide child care services for a duration of time that is greater than one hour while such licensee is absent, provided such licensee provides advance notice to the parents or guardians of children enrolled in the family child care home of the dates and times such substitute staff member will be providing such child care services and such licensee continues to maintain control of the day-to-day operations of the family child care home. No such use of a substitute staff member under this subdivision shall constitute a transfer or franchise of the family child care home.

(c) The commissioner shall require each initial applicant or prospective employee of a family child care home in a position requiring the provision of care to a child, including an assistant or substitute staff member, and each household member who is eighteen years of age or older, to submit to comprehensive background checks, including state and national criminal history records checks. The criminal history records checks required pursuant to this subsection shall be conducted in accordance with section 29-17a. The commissioner shall also request a check of the state child abuse registry established pursuant to section 17a-101k. The commissioner shall notify each licensee of the provisions of this subsection. For purposes of this subsection, “household member” means any person, other than the person who is licensed to conduct, operate or maintain a family child care home, who resides in the family child care home, such as the licensee's spouse or children, tenants and any other occupant.

(d) An application for initial licensure pursuant to this section shall be accompanied by a fee of forty dollars and such license shall be issued for a term of four years. An application for renewal of a license issued pursuant to this section shall be accompanied by a fee of forty dollars and a certification from the licensee that any child enrolled in the family child care home has received age-appropriate immunizations in accordance with regulations adopted pursuant to subsection (f) of this section. A license issued pursuant to this section shall be renewed for a term of four years. In the case of an applicant submitting an application for renewal of a license that has expired, and who has ceased operations of a family child care home due to such expired license, the commissioner may renew such expired license within thirty days of the date of such expiration upon receipt of an application for renewal that is accompanied by such fee and such certification.

(e) An application for initial staff approval or renewal of staff approval shall be accompanied by a fee of fifteen dollars. Such approvals shall be issued or renewed for a term of two years.

(f) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to ensure that family child care homes, as described in section 19a-77, meet the health, educational and social needs of children utilizing such homes. Such regulations shall (1) ensure that the family child care home is treated as a residence, and not an institutional facility, (2) specify that each child be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f, (3) specify conditions under which family child care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administer medicinal preparations, including controlled drugs specified in the regulations by the commissioner, to a child receiving child care services at a family child care home pursuant to a written order of a physician licensed to practice medicine in this or another state, an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a or a physician assistant licensed to prescribe in accordance with section 20-12d, and the written authorization of a parent or guardian of such child, (4) specify appropriate standards for extended care and intermittent short-term overnight care, (5) specify that a family child care home shall immediately notify the parent or guardian of a child enrolled in such home if such child exhibits or develops an illness or is injured while in the care of such home, (6) specify that a family child care home shall create a written record of any such illness or injury, which shall, (A) include, but not be limited to, (i) a description of such illness or injury, (ii) the date, time of occurrence and location of such illness or injury, (iii) any responsive action taken by an employee of such home, and (iv) whether such child was transported to a hospital emergency room, doctor's office or other medical facility as a result of such illness or injury, (B) be provided to the parent or guardian of such child not later than the next business day, and (C) be maintained by such home for a period of not less than two years and be made immediately available upon the request of the Office of Early Childhood, and (7) specify that a family child care home shall maintain any video recordings created at such home for a period of not less than thirty days, and make such recordings immediately available upon the request of the Office of Early Childhood. The commissioner shall inform each licensee, by way of a plain language summary provided not later than sixty days after the regulation's effective date, of any new or changed regulations adopted under this subsection with which a licensee must comply. For purposes of this subsection, “illness” means fever, vomiting, diarrhea, rash, headache, persistent coughing, persistent crying or any other condition deemed an illness by the Commissioner of Early Childhood.

(g) Any child who (1) presents a certificate, in a form prescribed by the Commissioner of Public Health pursuant to section 19a-7q, signed by a physician, a physician assistant or an advanced practice registered nurse stating that, in the opinion of such physician, physician assistant or advanced practice registered nurse, the immunizations required pursuant to regulations adopted pursuant to subsection (f) of this section are medically contraindicated, (2) in the case of a child who is enrolled in kindergarten through twelfth grade, presented a statement, prior to April 28, 2021, that such immunizations are contrary to the religious beliefs of such child or the parents or guardian of such child, or (3) in the case of a child who is enrolled in a preschool program or other prekindergarten program or below, (A) presented a statement, prior to April 28, 2021, that such immunizations are contrary to the religious beliefs of such child or the parents or guardian of such child, and (B) presents a written declaration, in a form prescribed by the Commissioner of Public Health, from a physician, physician assistant or advanced practice registered nurse stating that an immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f has been given to such child and that any additional necessary immunizations of such student against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, haemophilus influenzae type B and any other vaccine required by such schedule of active immunization are in process under guidelines specified by the Commissioner of Public Health or as recommended for the child by the physician, physician assistant or advanced practice registered nurse, shall be exempt from the immunization requirements set forth in such regulations. The statement described in subparagraph (A) of subdivision (3) of this subsection shall be acknowledged, in accordance with the provisions of sections 1-32, 1-34 and 1-35, by (i) a judge of a court of record or a family support magistrate, (ii) a clerk or deputy clerk of a court having a seal, (iii) a town clerk, (iv) a notary public, (v) a justice of the peace, or (vi) an attorney admitted to the bar of this state.

(h) Any child who is enrolled in a preschool program or other prekindergarten program or below on or before April 28, 2021, who presented, prior to April 28, 2021, the statement described in subparagraph (A) of subdivision (3) of subsection (g) of this section, but did not present the written declaration described in subparagraph (B) of subdivision (3) of subsection (g) of this section shall comply, on or before September 1, 2022, or not later than fourteen days after applying to enroll in the family child care home, whichever is later, with the immunization requirements set forth in the regulations adopted pursuant to subsection (f) of this section.

(i) Upon the declaration by the Governor of a civil preparedness emergency pursuant to section 28-9 or a public health emergency pursuant to section 19a-131a, the commissioner may waive the provisions of any regulation adopted pursuant to this section if the commissioner determines that such waiver would not endanger the life, safety or health of any child. The commissioner shall prescribe the duration of such waiver, provided such waiver shall not extend beyond the duration of the declared emergency. The commissioner shall establish the criteria by which a waiver request shall be made and the conditions for which a waiver will be granted or denied. The provisions of section 19a-84 shall not apply to a denial of a waiver request under this subsection.

(j) Any family child care home may provide child care services to homeless children and youths, as defined in 42 USC 11434a, as amended from time to time, for a period not to exceed ninety days without complying with any provision in regulations adopted pursuant to this section relating to immunization and physical examination requirements. Any family child care home that provides child care services to homeless children and youths at such home under this subsection shall maintain a record on file of all homeless children and youths who have attended such home for a period of two years after such homeless children or youths are no longer receiving child care services at such home.

(k) Any family child care home may provide child care services to a foster child for a period not to exceed forty-five days without complying with any provision in regulations adopted pursuant to this section relating to immunization and physical examination requirements. Any family child care home that provides child care services to a foster child at such home under this subsection shall maintain a record on file of such foster child for a period of two years after such foster child is no longer receiving child care services at such home. For purposes of this subsection, “foster child” means a child who is in the care and custody of the Commissioner of Children and Families and placed in a foster home licensed pursuant to section 17a-114, foster home approved by a child-placing agency licensed pursuant to section 17a-149, facility licensed pursuant to section 17a-145 or with a relative or fictive kin caregiver pursuant to section 17a-114.

(l) For the fiscal years ending June 30, 2022, to June 30, 2026, inclusive, the Commissioner of Early Childhood may issue a license to maintain a family child care home in New Britain, New Haven, Bridgeport, Stamford, Hartford, Danbury or Waterbury in accordance with the provisions of this chapter to a person or group of persons who have partnered with an association, organization, corporation, institution or agency, public or private, to provide child care services in a space provided by such association, organization, corporation, institution or agency, provided such space has been approved by the commissioner and is not in a private family home. The commissioner shall not approve more than one facility in each such city to be used for licenses issued under this subsection. An application for a license under this subsection shall include a copy of the current fire marshal certificate of compliance with the Fire Safety Code, and written verification of compliance with the State Building Code, local zoning and building requirements and local health ordinances. The commissioner may require an applicant for a license under this subsection to comply with additional conditions relating to the health and safety of the children who will be served in such facility. The commissioner may waive any requirement that does not apply to such facility. Any license issued under this subsection shall expire on June 30, 2026, except that the commissioner may suspend or revoke any such license at any time in accordance with the provisions of section 19a-87e.

(P.A. 94-181, S. 1, 7; P.A. 95-257, S. 12, 21, 58; 95-360, S. 13, 32; P.A. 96-19, S. 1; 96-180, S. 55, 166; P.A. 97-14, S. 2; 97-259, S. 36, 41; P.A. 98-250, S. 15, 39; June Sp. Sess. P.A. 98-1, S. 79, 121; June Sp. Sess. P.A. 99-2, S. 70; P.A. 00-27, S. 11, 12, 24; P.A. 01-175, S. 16, 32; P.A. 03-243, S. 12; P.A. 05-207, S. 10; P.A. 07-129, S. 4; June Sp. Sess. P.A. 09-3, S. 169; P.A. 11-242, S. 17; P.A. 13-208, S. 6; P.A. 14-39, S. 56; P.A. 15-174, S. 3; 15-227, S. 8, 25; P.A. 16-131, S. 1; June Sp. Sess. P.A. 17-2, S. 175; P.A. 18-172, S. 2; P.A. 19-121, S. 3; P.A. 21-6, S. 6; 21-171, S. 1; 21-172, S. 8; P.A. 22-81, S. 15; P.A. 23-142, S. 3.)

History: P.A. 94-181 transferred responsibility for licensing family day care homes from social services department to public health and addiction services department, as a result of which Subsecs. (b) to (d), inclusive, were transferred editorially by the Revisors to Sec. 19a-87a in 1995; P.A. 94-181 also added provision in Subsec. (c) requiring regulations to ensure family day care homes are treated as residences rather than as institutional facilities, effective July 1, 1994; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 95-360 deleted department's authority to purchase services in Subsec. (a) and amended Subsec. (c) to establish increase in fees after 1995, effective July 13, 1995; P.A. 96-19 expanded written orders by physicians in Subsec. (b) to include advanced practice registered nurses and physician assistants; P.A. 96-180 made a technical change in Subsec. (a), substituting reference to Sec. 53a-157b for Sec. 53a-157, effective June 3, 1996; P.A. 97-14 added provision re diabetes monitoring in former Subsec. (b); P.A. 97-259 added new Subsec. (b) re criminal records checks and child abuse registry checks and redesignated for Subsecs. (b) and (c) as Subsecs. (c) and (d), effective July 1, 1997; P.A. 98-250 amended Subsec. (c) to require plain language summary of regulations, effective July 1, 1998; June Sp. Sess. P.A. 98-1 made a technical change in Subsec. (b), effective June 24, 1998; June Sp. Sess. P.A. 99-2 amended Subsec. (b) by changing “criminal records check” and “criminal history records checks” to “fingerprint criminal records check” and “fingerprint criminal history records checks”; P.A. 00-27 made technical changes in Subsecs. (a) and (d), effective May 1, 2000; P.A. 01-175 amended Subsec. (b) by replacing language re fingerprint criminal records checks as a permissive request with language re mandatory state and national criminal history records checks pursuant to Sec. 29-17a, deleted language re fee and made technical changes, effective July 1, 2001; P.A. 03-243 added “for perpetrator information” in Subsec. (b); P.A. 05-207 amended Subsec. (b) to delete requirement that commissioner request check of state child abuse registry for perpetrator information; P.A. 07-129 amended Subsec. (a) to prohibit commissioner's designee from requiring annual inspection and to allow commissioner's designee to make unannounced visits during customary business hours, amended Subsec. (d) to limit $20 fee for initial licensure and license renewals to applications submitted prior to October 1, 2008, and added Subsec. (e) to extend the license term from 2 to 4 years and increase license fee from $20 to $40 for licenses issued on and after October 1, 2008; June Sp. Sess. P.A. 09-3 amended Subsec. (e) to increase license fee from $40 to $80; P.A. 11-242 added new Subsec. (b) re approval to act as assistant or substitute staff member in a family day care home, redesignated existing Subsec. (b) as Subsec. (c) and amended same to add provision re assistant or substitute staff member, added new Subsec. (d) re $40 license fee, 4-year license term and child immunization requirements, added new Subsec. (e) re initial and renewal applications for staff approval, redesignated existing Subsec. (c) as Subsec. (f) and deleted former Subsecs. (d) and (e) re license applications submitted prior to October 1, 2008, and licenses issued on and after October 1, 2008; P.A. 13-208 amended Subsec. (b)(3) to increase fee from $15 to $20; P.A. 14-39 replaced references to Commissioner and Department of Public Health with references to Commissioner and Office of Early Childhood and amended Subsec. (a) by replacing provision re unannounced visits to at least 33 1/3 per cent of licensed family day care homes each year with provision re unannounced visit, inspection or investigation of each licensed family day care home at least once every year, effective July 1, 2014; P.A. 15-174 amended Subsec. (f) to add provision re objection on religious grounds to be accompanied by acknowledged statement that immunization would be contrary to religious beliefs, effective July 1, 2015; P.A. 15-227 replaced “family day care home” and “family day care homes” with “family child care home” and “family child care homes”, respectively, amended Subsec. (d) by adding provisions re renewal of expired license, amended Subsec. (f) by replacing “day care services” with “child care services”, and added Subsec. (g) re waiver of regulations during civil preparedness or public health emergency, effective July 1, 2015; P.A. 16-131 amended Subsec. (c) by adding provision re household member who is age 16 or older and adding definition of “household member”, effective June 7, 2016; June Sp. Sess. P.A. 17-2 amended Subsec. (c) by adding “comprehensive background checks, including”, effective October 31, 2017; P.A. 18-172 made a technical change in Subsec. (f) and added Subsec. (h) re provision of child care services to homeless children and youths for period not to exceed 90 days without complying with immunization and physical examination requirements, effective July 1, 2018; P.A. 19-121 added Subsec. (i) re provision of child care services to foster child for period not to exceed 45 days without complying with immunization and physical examination requirements, effective July 1, 2019; P.A. 21-6 amended Subsec. (f) by making a technical change and deleting provisions re adoption of regulations re exemptions from immunization requirements, added new Subsec. (g) re exemptions from immunization requirements, add new Subsec. (h) re compliance with Subsec. (g)(3) for certain children and redesignated existing Subsecs. (g) to (i) as Subsecs. (i) to (k), effective April 28, 2021; P.A. 21-171 amended Subsec. (a) by replacing “defined” with “described”, amended Subsec. (b) by designating existing provisions as new Subdiv. (1) and redesignating existing Subdivs. (1) to (3) as Subparas. (A) to (C) and adding new Subdiv. (2) re provision of child care services by substitute staff members while licensee is absent, amended Subsec. (f) to replace “assure” with “ensure” and “defined” with “described”, and added Subsec. (j), codified by the Revisors as Subsec. (l) re license to maintain a family child care home in facility that is not a private family home in New Britain, New Haven, Bridgeport, Stamford, Hartford, Danbury or Waterbury, effective July 1, 2021; P.A. 21-172 amended Subsec. (c) by deleting “, within available appropriations,”, replacing “sixteen” with “eighteen”, and making a technical change; P.A. 22-81 amended Subsec. (f) by designating existing provision re ensuring family child care home is treated as residence as Subdiv. (1), designating existing provision re immunization as Subdiv. (2), designating existing provision re administration of glucose monitoring tests and medicinal preparations as Subdiv. (3), designating existing provision re standards for extended and intermittent short-term overnight care as Subdiv. (4), adding Subdiv. (5) re notification of illness or injury, adding Subdiv. (6) re written record of illness or injury, adding Subdiv. (7) re video recordings, defining “illness”, and making technical changes, effective July 1, 2022; P.A. 23-142 amended Subsec. (a) to specify that any licensed family child care home is subject to all applicable codes or ordinances.

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Sec. 19a-89e. Development of prospective nurse staffing plan by hospitals. Report. (a) For purposes of this section:

(1) “Department” means the Department of Public Health;

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

(3) “Assistive personnel” means personnel who are not licensed by the Department of Public Health and who engage in specifically delegated patient care activities; and

(4) “Direct care registered nurse” means a registered nurse licensed pursuant to chapter 378 whose primary responsibility is to provide direct patient care.

(b) Each hospital licensed by the department pursuant to chapter 368v shall report, not later than January first and July first annually, to the department on a prospective nurse staffing plan with a written certification that the nurse staffing plan developed pursuant to subsections (d) and (e) of this section is sufficient to provide adequate and appropriate delivery of health care services to patients in the ensuing period of licensure. Such plan shall promote a collaborative practice in the hospital that enhances patient care and the level of services provided by nurses and other members of the hospital's patient care team.

(c) (1) Each hospital shall establish a dedicated hospital staffing committee to assist in the preparation of the nurse staffing plan required pursuant to subsection (b) of this section. Direct care registered nurses employed by the hospital shall account for not less than fifty per cent and an odd number of members of the membership of each hospital's staffing committee. The total number of direct care registered nurses shall be one more than the total number of nondirect care registered nurses of such committee. Each hospital's staffing committee shall include broad-based representation across hospital services. When registered nurses employed by the hospital are members of a collective bargaining unit, (A) the collective bargaining unit shall select the direct care registered nurse members that comprise not less than fifty per cent of the total number of members of such committee, provided such selection is not prohibited conduct under the National Labor Relations Act, 29 USC 151, et seq., as amended from time to time, 5 USC 71, as amended from time to time, or the State Employee Relations Act, section 5-270, et seq., as amended from time to time, and (B) a representative of the collective bargaining unit shall provide the hospital with a list of multiple names of direct care registered nurses from which hospital management shall select the one additional direct care registered nurse member beyond the fifty per cent of the direct care registered nurse members. Direct care registered nurses who are not members of a collective bargaining unit shall be selected for the committee through a process determined by the direct care registered nurses of the hospital. The hospital staffing committee that was in existence prior to October 1, 2023, shall solicit feedback from all direct care registered nurses employed by the hospital regarding what such process should entail. The direct care registered nurses who are members of such existing hospital staffing committee shall decide, by majority vote, the parameters of such process. Hospital management shall select the remaining members of such committee.

(2) Each hospital shall pay each employee who serves on the hospital staffing committee such employee's regular rate of pay, including differentials, for participation on the committee and consider, to the extent possible by the hospital, the time such employee serves on the committee as part of such employee's regularly scheduled work week. Each hospital shall ensure that direct care registered nurses have coverage to attend hospital staffing committee meetings.

(3) Each hospital staffing committee shall include two cochairpersons who have direct patient care experience, one of whom is a direct care registered nurse at the hospital who shall be elected by members of the committee who are direct care registered nurses, and one of whom shall be elected by members of the committee who are not direct care registered nurses. The committee shall take minutes of every meeting, make such minutes available to any member of the hospital staff upon request and submit such minutes to the Department of Public Health when requested by the department. A majority of the members of the staffing committee shall constitute a quorum for the transaction of staffing committee business. A decision made by the hospital staffing committee shall be made by a vote of a majority of the members present at the meeting. If a quorum of members present at a meeting comprises an equal number of members who are direct care registered nurses and members who are not direct care registered nurses, a sufficient number of members who are not direct care registered nurses shall abstain from voting to allow a majority of the voting members to consist of direct care registered nurses.

(4) Each hospital shall notify each nurse on the nurse's date of hire, and annually thereafter, about the hospital staffing committee, including, but not limited to, the purpose of the committee, the criteria and process for becoming a member of the committee, the hospital's process for internal review of the nurse staffing plan and the hospital's mechanism for obtaining input from direct care staff, including direct care registered nurses and other members of the hospital's patient care team, in the development of the nurse staffing plan.

(d) Each hospital staffing committee shall develop the nurse staffing plan for the hospital. In developing such plan, the committee shall evaluate the most recent research regarding patient outcomes, share with hospital staff the procedures for communicating concerns to the committee regarding such plan and staffing assignments and review all reports regarding any such concerns and any objections or refusals by a registered nurse to participate in a staffing assignment made pursuant to subsection (h) of this section that were communicated to the committee. Each hospital shall implement such plan. Such plan shall: (1) Include the minimum professional skill mix for each patient care unit in the hospital, including, but not limited to, inpatient services, critical care and the emergency department; (2) identify the hospital's employment practices concerning the use of temporary and traveling nurses; (3) set forth the level of administrative staffing in each patient care unit of the hospital that ensures direct care staff are not utilized for administrative functions; (4) set forth the hospital's process for internal review of the nurse staffing plan; and (5) include the hospital's mechanism of obtaining input from direct care staff, including nurses and other members of the hospital's patient care team, in the development of the nurse staffing plan. In addition to the information described in subdivisions (1) to (5), inclusive, of this subsection, nurse staffing plans developed and implemented after January 1, 2016, shall include: (A) The number of registered nurses providing direct patient care and the ratio of patients to such registered nurses by patient care unit; (B) the number of licensed practical nurses providing direct patient care and the ratio of patients to such licensed practical nurses, by patient care unit; (C) the number of assistive personnel providing direct patient care and the ratio of patients to such assistive personnel, by patient care unit; (D) the method used by the hospital to determine and adjust direct patient care staffing levels; and (E) a description of assistive personnel on each patient care unit. In addition to the information described in subdivisions (1) to (5), inclusive, of this subsection and subparagraphs (A) to (E), inclusive, of this subdivision, nurse staffing plans developed and implemented after January 1, 2017, shall include: (i) A description of any differences between the staffing levels described in the staffing plan and actual staffing levels for each patient care unit; and (ii) any actions the hospital intends to take to address such differences or adjust staffing levels in future staffing plans.

(e) On and after January 1, 2024, in addition to the information required pursuant to subsection (d) of this section, each nurse staffing plan shall include:

(1) Information about any objections to or refusals to comply with the nurse staffing plan by hospital staff that were communicated to the hospital staffing committee;

(2) Measurements of and evidence to support successful implementation of the nurse staffing plan;

(3) Retention, turnover and recruitment metrics for direct care registered nursing staff, including, but not limited to, the turnover rate per hospital unit during the preceding twelve months and the average years of experience of permanent direct care registered nursing staff per unit;

(4) The number of instances since the last nurse staffing plan was submitted when the hospital was not in compliance with such plan, including, but not limited to, the nurse staffing ratios set forth in such plan, and a description of how and why such plan was not complied with and plans to avoid future noncompliance with such plan; and

(5) Certification that the hospital and its hospital staffing committee are meeting the requirements set forth in this section and a description of how each requirement is being met.

(f) Each hospital shall post the nurse staffing plan developed and adopted pursuant to subsections (d) and (e), inclusive, of this section on each patient care unit in a conspicuous location visible and accessible to staff, patients and members of the public. Each hospital shall maintain accurate records, for not less than the preceding three years, of the ratios of patients to direct care registered nurses and patients to assistive personnel providing patient care in each direct care unit for each shift. Such records shall include the number of (1) patients in each unit on each shift, (2) direct care registered nurses assigned to each patient in each unit on each shift, and (3) assistive personnel providing patient care assigned to each patient in each unit on each shift. Each hospital shall make such records available, upon request, to the Department of Public Health, the staff of the hospital, any collective bargaining unit representing such staff, the patients of the hospital and members of the general public.

(g) No hospital shall require a registered nurse to undertake any patient care task that is beyond the scope of the nurse's license.

(h) A registered nurse may object to or refuse to participate in any activity, policy, practice or task assigned by a hospital if the registered nurse is not competently able based on education, training or experience to participate in the activity, policy, practice or task without compromising the safety of a specific patient. If a registered nurse objects or refuses to participate, the nurse shall immediately contact a supervisor for assistance or to allow the hospital to find a suitable replacement. Not later than twelve hours after objecting or refusing to participate, the registered nurse shall submit a form, developed by the hospital and approved by the Department of Public Health, that includes the following: (1) A detailed statement of the reasons that the nurse objects or refuses to participate in the activity, policy, practice or task; (2) a description of how performing the activity, policy, practice or task would have compromised patient safety; and (3) the ways in which the activity, policy, practice or task was not consistent with the nurse's education, training, experience or job description. A hospital shall review and analyze each form submitted pursuant to this subsection through one or more of the hospital's committees or functions, including, but not limited to, the quality assessment and performance improvement program, risk management or patient safety, and make adjustments to nurse staffing assignments if necessary to improve patient safety. Each hospital shall provide the Department of Public Health with confidential access to the forms submitted to the hospital pursuant to this subsection upon request.

(i) If a registered nurse reasonably believes his or her participation in an activity, policy, practice or task would violate a provision of a nurse staffing plan or policy approved by the hospital's nurse staffing committee, the nurse may file a complaint with the nurse staffing committee on a form developed by the hospital and approved by the Department of Public Health. The hospital and its nurse staffing committee shall analyze the complaint and provide the Department of Public Health with an analysis of actions taken in response to such complaint. The department shall submit all complaint forms provided to it pursuant to this subsection with its biannual report required pursuant to subsection (n) of this section.

(j) No hospital shall discharge, retaliate against, discriminate against or take any other adverse action against a registered nurse or any aspect of the registered nurse's employment, including, but not limited to, discharge, promotion, reduction in compensation or changes to terms, conditions or privileges of employment, as a result of such nurse taking any of the actions described in this section, participation by the registered nurse in a hospital staffing committee or raising of concerns by the registered nurse regarding unsafe staffing or workplace violence, racism or bullying.

(k) Nothing in this section shall be construed to allow a nurse to abandon a patient or refuse to perform patient care activities (1) during an ongoing surgical procedure until such procedure is completed; (2) in a critical care unit, labor and delivery or emergency department until such nurse is relieved by another nurse; (3) in the case of a public health emergency; (4) in the case of an institutional emergency; or (5) in any instance where inaction or abandonment by the nurse would jeopardize patient safety.

(l) Nothing in this section shall prohibit a hospital, the Department of Public Health or the State Board of Examiners for Nursing from requiring a nurse to obtain additional training or continuing education consistent with the nurse's assigned roles and job description.

(m) Not later than January 1, 2016, and annually thereafter, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to public health concerning hospital compliance with reporting requirements under this section and recommendations concerning any additional reporting requirements.

(n) Not later than October 1, 2024, and biannually thereafter, a hospital shall report to the Department of Public Health, in a form and manner prescribed by the Commissioner of Public Health, whether it has been in compliance, for the previous six months, with at least eighty per cent of the nurse staffing assignments as required by any component outlined in the nurse staffing plan developed pursuant to subsections (d) and (e) of this section.

(o) For a failure by a hospital to (1) establish or maintain a hospital staffing committee pursuant to subsection (c) of this section, (2) submit the report required by subsection (n) of this section to the Department of Public Health, (3) post the staffing plan pursuant to subsection (f) of this section, or (4) comply with at least eighty per cent of the nurse staffing assignments set forth in the nurse staffing plan, the Commissioner of Public Health shall issue an order that: (A) Requires the hospital to submit a corrective action plan to correct such noncompliance and implement such plan unless disapproved by the department not later than twenty business days after its submission; and (B) (i) imposes a civil penalty of three thousand five hundred dollars for the first violation, or (ii) imposes a civil penalty of five thousand dollars for each subsequent violation.

(p) (1) A hospital shall, not later than five business days after receipt of an order pursuant to subsection (o) of this section, submit a request in writing to the Department of Public Health for a hearing to contest the order. If the hospital fails to submit such a request not later than five business days after such receipt, the order shall be deemed a final order of the department, effective upon the expiration of such five business days. After receipt of a timely request for a hearing, the department shall set the matter down for a hearing as a contested case in accordance with the provisions of chapter 54.

(2) Each hospital shall pay any civil penalties imposed pursuant to subsection (o) of this section not later than fifteen days after the final date by which an appeal may be taken as provided in section 4-183 or, if an appeal is taken, not later than fifteen days after the final judgment on such appeal. If such penalties or the expenses of an audit ordered under subsection (q) of this section are not paid by the hospital, the Commissioner of Public Health shall notify the Commissioner of Social Services who shall be authorized to immediately withhold from the hospital's next medical assistance payment, an amount equal to the amount of the civil penalty and audit expenses.

(q) The Commissioner of Public Health may order an audit of the nurse staffing assignments of each hospital to determine compliance with the nurse staffing assignments for each hospital unit set forth in the nurse staffing plan developed pursuant to subsections (d) and (e) of this section. Such audit may include an assessment of the hospital's compliance with the requirements of this section for the content of such plan, accuracy of reports submitted to the department and the membership of the hospital staffing committee. In determining whether to order an audit, the commissioner shall consider whether there has been consistent noncompliance by the hospital with the nurse staffing plan, fear of false reporting by the hospital, or any other health care quality safety concerns. The hospital that is subject to the audit shall pay the cost of the audit. The audit shall not affect the conduct by the hospital of peer review as defined in section 19a-17b.

(P.A. 08-79, S. 1; P.A. 15-91, S. 1; P.A. 23-204, S. 54.)

History: P.A. 15-91 amended Subsec. (b) to replace provision re plan made available upon request with provision re annual report on plan, amended Subsec. (c) to add provisions re information to be included in nurse staffing plans developed and implemented after January 1, 2016, and after January 1, 2017, and added Subsec. (d) re report concerning compliance and recommendations, effective July 1, 2015; P.A. 23-204 amended Subsec. (a) by adding Subdiv. (3) defining “assistive personnel” and Subdiv. (4) defining “direct care registered nurse”, Subsec. (b) by adding January and July first deadlines and reference to Subsecs. (d) and (e), Subsec. (c) by designating existing provisions re establishing a hospital staffing committee as Subdiv. (1) and amending same by inserting “dedicated”, replacing reference to “registered” with “direct care registered”, making technical changes, adding provision requiring direct care registered nurses to account for an odd number of members of the hospital staffing committee, replacing existing provisions re utilization of existing committees to assist in preparation of plan with provisions re membership of the committee, adding Subdiv. (2) re payment for services, adding Subdiv. (3) re chairpersons, taking minutes, quorum requirements and voting and adding Subdiv. (4) re notification re the hospital staffing committee, added new Subsec. (d) designator before existing provisions re implementation of the nurse staffing plan, made technical changes thereto and added new provisions re development of the plan by the hospital staffing committee, added Subsec. (e) re requirements for nurse staffing plan on and after January 1, 2024, added Subsec. (f) re posting of the nurse staffing plan and maintaining records of ratios of patients to direct care registered nurses and assistive personnel, added Subsec. (g) prohibiting hospital from requiring registered nurses to undertake any task beyond their scope, added Subsec. (h) re registered nurse's authority to object to or refuse to participate in certain activities, policies, practices or tasks, added Subsec. (i) re registered nurse's authority to file a complaint with the nurse staffing committee, added Subsec. (j) re prohibition on hospital's ability to discharge, retaliate against, discriminate against or take any other adverse action against a registered nurse, added Subsec. (k) prohibiting a nurse from abandoning a patient or refusing to perform certain patient care activities, added Subsec. (l) re authority of the department to require additional training or continuing education, redesignated existing Subsec. (d) as Subsec. (m) and made a technical change thereto, added Subsec. (n) re reporting to the department re compliance with the nurse staffing assignments, added Subsec. (o) re penalties for failure to establish or maintain a hospital staffing committee, submit the required report, post staffing plan or comply with at least 80 per cent of the staffing assignments, added Subsec. (p) re hearing to contest an order and payment of civil penalties, and added Subsec. (q) re ordering an audit of nurse staffing assignments.

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Sec. 19a-91a. Out-of-state funeral director access to electronic death registry system. The Commissioner of Public Health shall provide funeral directors licensed pursuant to chapter 385 who operate or are affiliated with a funeral home or funeral service business that (1) is located in another state, and (2) has a reciprocal agreement on file with the Department of Public Health, with access to the electronic death registry system.

(P.A. 23-31, S. 49.)

History: P.A. 23-31 effective January 1, 2024.

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Sec. 19a-109aa. (Formerly Sec. 19a-111f). Environmentally safe housing for children and families program. (a) For purposes of this section:

(1) “Commissioner” means the Commissioner of Public Health;

(2) “Eligible families” means any household which (A) is eligible for the federal Medicaid program, (B) includes a child who is six years of age or younger, and (C) is residing in a building built prior to 1978; and

(3) “The program” or “this program” means the program established by this section.

(b) The Commissioner of Public Health may establish a program to promote environmentally safe housing for children and families through education, medical screening and appropriate and cost-effective repairs. Such program may (A) identify eligible families and, through voluntary home visits, provide education about the problems caused by exposure to lead and how to avoid or lessen the effects of such exposure, (B) provide blood lead screening for children who are six years of age or younger, (C) identify measures to be taken to lessen the effects from the presence of lead, including window repair or replacement, and (D) apply to federal programs and to other funding sources which will pay for some of the costs of this program. The commissioner may contract with a nonprofit entity to operate the program.

(c) Eligible costs by a nonprofit entity operating this program shall include costs and expenses incurred in providing lead-safety education, interim measures and window repair or replacement or other remediation for dwelling units, administrative and management expenses, planning and start-up costs, and any other costs and expenses found by the commissioner to be necessary and reasonable and in accordance with existing state regulations.

(P.A. 00-216, S. 26, 28; P.A. 23-31, S. 28.)

History: P.A. 00-216 effective July 1, 2000; Sec. 19a-111f transferred to Sec. 19a-109aa in 2009; P.A. 23-31 amended Subsec. (a)(2)(B) by deleting “as of July 1, 2000,”, and amended Subsec. (b) by deleting Subpara. (E) re continual evaluation of program progress and making a conforming change.

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Sec. 19a-110. (Formerly Sec. 19-65e). Report of lead poisoning. Parental notification. Availability of information regarding lead poisoning. (a) As used in this section, and sections 19a-110a to 19a-111k, inclusive:

(1) “Abatement” means any set of measures designed to reduce or eliminate lead hazards, including, but not limited to, the encapsulation, replacement, removal, enclosure or covering of paint, plaster, soil or other material containing toxic levels of lead and all preparation, clean-up, disposal and reoccupancy clearance testing;

(2) “Epidemiological investigation” means an examination and evaluation by a lead inspector certified under chapter 400c to determine the cause of elevated blood levels, detect lead-based paint and report findings and (A) includes (i) an on-site inspection and, if applicable, an inspection of other dwellings or areas frequented by a person with elevated blood lead levels that may be the source of a lead hazard, and (ii) an evaluation of other potential sources of lead hazards, including, but not limited to, drinking water, soil, dust, pottery, gasoline, toys or occupational exposure, and (B) may include isotopic analysis of lead-containing items;

(3) “Lead screening” means a blood lead test from a finger-prick or venous blood draw;

(4) “On-site inspection” means an examination of a residential dwelling to identify lead hazards, including, but not limited to, an examination of the dwelling for deteriorating paint, lead dust, bare soil near the perimeter of the dwelling, household items that may present a potential lead risk, such as toys, cookware, food products and cosmetics, and an inquiry into the water system serving the dwelling;

(5) “Remediation” means the process of remedying a lead hazard condition, including, but not limited to, investigation, abatement and, if appropriate, ongoing management measures; and

(6) “Risk assessment” means the collection of information about a person's potential lead exposures and a determination of whether such person has an increased likelihood of an elevated blood lead level.

(b) Not later than forty-eight hours after receiving or completing a report of a person found to have a level of lead in the blood equal to or greater than three and one-half micrograms per deciliter of blood or any other abnormal body burden of lead, each institution licensed under sections 19a-490 to 19a-503, inclusive, and each clinical laboratory licensed under section 19a-565 shall report to (1) the Commissioner of Public Health, and to the director of health of the town, city, borough or district in which the person resides: (A) The name, full residence address, date of birth, gender, race and ethnicity of each person found to have a level of lead in the blood equal to or greater than three and one-half micrograms per deciliter of blood or any other abnormal body burden of lead; (B) the name, address and telephone number of the health care provider who ordered the test; (C) the sample collection date, analysis date, type and blood lead analysis result; and (D) such other information as the commissioner may require, in a form and manner as prescribed by the commissioner, and (2) the health care provider who ordered the test, the results of the test. With respect to a child under three years of age, not later than twenty-four hours after the provider receives such results, the provider shall make reasonable efforts to notify the parent or guardian of the child of the blood lead analysis results. Any institution or laboratory making an accurate report in good faith shall not be liable for the act of disclosing such report to the Commissioner of Public Health or to the director of health. The commissioner shall determine the form and manner of transmission of data contained in such report.

(c) Each institution or laboratory that reports lead testing pursuant to this section shall, at least monthly, submit to the Commissioner of Public Health a comprehensive report that includes: (1) The name, full residence address, date of birth, gender, race and ethnicity of each person tested pursuant to subsection (b) of this section regardless of the level of lead in the blood; (2) the name, address and telephone number of the health care provider who ordered the test; (3) the sample collection date, analysis date, type and blood lead analysis result; (4) laboratory identifiers; and (5) such other information as the Commissioner of Public Health may require. Any institution or laboratory making an accurate report in good faith shall not be liable for the act of disclosing such report to the Commissioner of Public Health. The Commissioner of Public Health shall determine the form and manner of transmission of data contained in such report.

(d) Whenever an institutional laboratory or private clinical laboratory reporting blood lead tests pursuant to this section refers a blood lead sample to another laboratory for analysis, the laboratories may agree on which laboratory will report in compliance with subsections (b) and (c) of this section, but both laboratories shall be accountable to ensure that reports are made. The referring laboratory shall ensure that the requisition slip includes all of the information that is required in subsections (b) and (c) of this section and that this information is transmitted with the blood specimen to the laboratory performing the analysis.

(1971, P.A. 22, S. 1; P.A. 77-614, S. 323, 610; P.A. 87-394, S. 1, 7; P.A. 92-192, S. 1, 5; P.A. 93-321, S. 1, 6; 93-381, S. 9, 39; 93-435, S. 59, 95; P.A. 95-257, S. 12, 21, 58; June 18 Sp. Sess. P.A. 97-9, S. 23, 50; P.A. 98-66; June Sp. Sess. P.A. 07-2, S. 49, 50; P.A. 11-51, S. 76; P.A. 15-172, S. 1, 2; P.A. 22-49, S. 1; 22-118, S. 149; P.A. 23-31, S. 29.)

History: P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-65e transferred to Sec. 19a-110 in 1983; P.A. 87-394 substituted “.025” for “.04” milligrams in lead level measurement; P.A. 92-192 deleted requirement that practitioners of the healing arts report increased blood lead levels, deleted requirement of reports for suspected increase in blood lead level, changed reportable lead level from .025 milligrams per one hundred grams to ten micrograms per deciliter and added the requirement that the commissioner shall determine the method of transmission of data after consultation with the executive director of the office of information and technology; P.A. 93-321 added new Subsec. (b) requiring health directors to provide information to parents and guardians of children reported; P.A. 93-381 and P.A. 93-435 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; June 18 Sp. Sess. P.A. 97-9 amended Subsec. (a) by substituting “Chief Information Officer” for “executive director of the Office of Information and Technology”, effective July 1, 1997; P.A. 98-66 amended Subsec. (a) by changing “registered” laboratories to “licensed” laboratories, changing “address” to “full residence address”, replacing “such other relevant information as said commissioner may require” with “gender, race and ethnicity”, adding Subdivs. (2), (3) and (4), replacing “such a report” with “an accurate report”, deleting immunity from civil or criminal liability and adding “not liable for the act of disclosing said report to the commissioner or to the director of health”, made a technical change re title of Chief Information Officer and required commissioner to determine “format” as well as method, added new Subsecs. (b) and (c) and relettered Subsec. (b) as (d); June Sp. Sess. P.A. 07-2 amended Subsec. (a) to extend applicability to all clinical laboratories, not just private clinical laboratories, to trigger reporting requirements when blood lead analysis results equal or exceed 10 micrograms per deciliter of blood, to redesignate existing Subdivs. (1) to (4) as Subparas. (A) to (D), to designate as Subdiv. (1) existing provisions re reports to Commissioner of Public Health and local directors of health and to add new Subdiv. (2) re reports to health care providers and notice to parents and guardians, effective October 1, 2007, and amended Subsec. (d) to require local directors of health to provide parents and guardians with information about potential eligibility for birth-to-three services and to add provisions requiring such directors to conduct inspections and order remediation whenever a confirmed venous blood lead level equals or exceeds 15 micrograms per deciliter but is less than 20 micrograms per deciliter or, on and after January 1, 2012, equals or exceeds 10 micrograms per deciliter, effective January 1, 2009; pursuant to P.A. 11-51, “Chief Information Officer of the Department of Information Technology” was changed editorially by the Revisors to “Commissioner of Administrative Services” in Subsecs. (a) and (b), effective July 1, 2011; P.A. 15-172 amended Subsec. (a)(1) by adding reference to district and amended Subsec. (d) by adding reference to district, replacing provision re child reported pursuant to Subsec. (a) with Subdiv. (1) re child known to have certain confirmed venous blood lead level and Subdiv. (2) re child who is the subject of a report and adding provision re information to be provided on one occasion; P.A. 22-49 amended Subsec. (a) by decreasing the blood lead level minimum from 10 micrograms per deciliter to 3 and one-half micrograms per deciliter and making technical changes, Subsecs. (b) and (c) by making technical changes, and Subsec. (d) by decreasing the blood lead level minimum from 5 micrograms per deciliter to 3 and one-half micrograms per deciliter, replacing “17a-248g” with “17a-248i” and redesignating existing provisions re conducting an on-site inspection as Subsec. (e) and amended same by adding a January 1, 2024, deadline, decreasing the blood lead level minimum from 15 micrograms per deciliter to 10 micrograms per deciliter and the blood lead level maximum from 20 micrograms per deciliter to 15 micrograms per deciliter, making a technical change, deleting provisions re an on-site inspection on and after January 1, 2012, and adding provisions re an on-site inspection from January 1, 2024, to December 31, 2024, effective January 1, 2023; P.A. 22-118 made identical changes as P.A. 22-49, effective January 1, 2023; P.A. 23-31 added new Subsec. (a) re definitions of “abatement”, “epidemiological investigation”, “lead screening”, “on-site inspection”, “remediation” and “risk assessment”, redesignated existing Subsec. (a) as Subsec. (b), amended Subsec. (b)(1)(D) by adding “in a form and manner as prescribed by the commissioner,”, amended Subsec. (b)(2) by replacing “seventy-two hours” with “twenty-four hours”, redesignated existing Subsecs. (b) and (c) as Subsecs. (c) and (d), deleted former Subsecs. (d) and (e), replaced references to conducting with references to reporting and “method and format” with “form and manner” throughout, deleted “, after consultation with the Commissioner of Administrative Services,” throughout, and made conforming changes throughout.

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Sec. 19a-110a. Regional lead poisoning treatment centers. Quarterly reports. (a) The Commissioner of Public Health may, within available appropriations, establish two regional lead poisoning treatment centers in different areas of the state by providing grants-in-aid to two participating hospitals, each with a demonstrated expertise in lead poisoning prevention and treatment as determined by the commissioner. Each center shall serve a designated area of the state, as determined by the commissioner, to provide services including, but not limited to, consultation services for pediatricians and other primary care practitioners regarding proper treatment of lead poisoning in children.

(b) Each regional lead poisoning treatment center shall report to the commissioner on a quarterly basis, in a form and manner prescribed by the commissioner, regarding the number of persons treated for lead poisoning, the residential town and race and ethnicity data for each such person and any other information that the commissioner may require.

(P.A. 92-192, S. 3, 5; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 23-31, S. 30.)

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Sec. 19a-111. (Formerly Sec. 19-65f). Informational materials. On-site inspection. Investigation. Preventive measures. Relocation of families. Reports. Regulations. (a) The Commissioner of Public Health shall develop informational materials describing the dangers of lead poisoning, precautions to reduce the risk of lead poisoning, potential eligibility for services for children from birth to three years of age pursuant to sections 17a-248 to 17a-248i, inclusive, laws and regulations concerning lead abatement and any other information as prescribed by the commissioner. The director of health of the town, city, borough or district shall provide, or cause to be provided, such informational materials to the parent or guardian of a child who is (1) known to have a blood lead level of three and one-half micrograms per deciliter of blood or more, or (2) the subject of a report by an institution or clinical laboratory, pursuant to section 19a-110. The director of health need only provide, or cause to be provided, such information to such parent or guardian on one occasion after receipt of an initial report of an abnormal blood lead level as described in section 19a-110.

(b) Upon receipt of each report of a child with a blood lead level (1) equal to or greater than ten micrograms per deciliter but less than fifteen micrograms per deciliter on or before January 1, 2024, and (2) equal to or greater than five micrograms per deciliter but less than ten micrograms per deciliter from January 1, 2024, to December 31, 2024, inclusive, the director shall conduct an on-site inspection to identify the source of the lead causing such blood lead level and order remediation of such source by the appropriate persons responsible for the conditions at such source.

(c) Upon receipt of each report of a blood lead level equal to or greater than fifteen micrograms per deciliter of blood from January 1, 2023, to December 31, 2023, inclusive, ten micrograms per deciliter of blood from January 1, 2024, to December 31, 2024, inclusive, and five micrograms per deciliter of blood on and after January 1, 2025, the local director of health shall make or cause to be made an epidemiological investigation of the source of the lead causing the increased lead level or abnormal body burden and shall order action to be taken by the appropriate person responsible for the condition that brought about such lead poisoning as may be necessary to prevent further exposure of persons to such poisoning. In the case of any residential unit where such action will not result in removal of the hazard within a reasonable time, the local director of health shall utilize such community resources as are available to effect relocation of any family occupying such unit. The local director of health may permit occupancy in said residential unit during abatement if, in such director's judgment, occupancy would not threaten the health and well-being of the occupants.

(d) The local director of health shall, not later than thirty days after the conclusion of such director's epidemiological investigation, report to the commissioner, using a web-based surveillance system as prescribed by the commissioner, the result of such investigation and the action taken to ensure against further lead poisoning from the same source, including any measures taken to effect relocation of families. Such report shall include information relevant to the identification and location of the source of lead poisoning and such other information as the commissioner may require pursuant to regulations adopted in accordance with the provisions of chapter 54. Nothing in this section shall be construed to prohibit a local building official from requiring abatement of sources of lead or to prohibit a local director of health from making or causing to be made an epidemiological investigation upon receipt of a report of a blood lead level that is less than the minimum blood level specified in this section.

(1971, P.A. 22, S. 2; P.A. 77-614, S. 323, 610; P.A. 87-394, S. 2, 7; P.A. 92-192, S. 2, 5; P.A. 93-321, S. 2, 6; 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 14-231, S. 8; P.A. 21-121, S. 5; P.A. 22-49, S. 2; 22-118, S. 150; P.A. 23-31, S. 31.)

History: P.A. 77-614 replaced commissioner of health with commissioner of health services, effective January 1, 1979; Sec. 19-65f transferred to Sec. 19a-111 in 1983; P.A. 87-394 added provisions re contents of reports, regulations, quarterly summaries and guidelines; P.A. 92-192 added provision that a blood lead level greater than twenty micrograms per deciliter of blood will cause an investigation to be conducted and added provisions that the guidelines established by the commissioner be consistent with those of the National Centers for Disease Control for assessment of the risk of lead poisoning, screening for lead poisoning and follow-up care; P.A. 93-321 added provision permitting occupancy during abatement, changed “may” to “shall” re establishment of guidelines, added treatment including children, pregnant women and women planning pregnancy and added provision affirming building officials' right to require abatement; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 14-231 deleted provision re quarterly summary of records and made technical changes; P.A. 21-121 added provision re use of web-based surveillance system as prescribed by the commissioner and made technical change; P.A. 22-49 decreased blood lead level minimum from 20 micrograms per deciliter to 15 micrograms per deciliter for January 1, 2023, to December 31, 2024, added provisions re minimum blood lead level from January 1, 2024, to December 31, 2024, and on and after January 1, 2025, and added provision permitting a director of health to investigate a report of a confirmed blood lead level less than the minimum specified in this section, effective January 1, 2023; P.A. 22-118 made identical changes as P.A. 22-49, effective January 1, 2023; P.A. 23-31 added Subsec. (a) re informational materials and Subsec. (b) re on-site inspections, designated existing provisions as Subsecs. (c) and (d), amended Subsecs. (c) and (d) by deleting “confirmed venous”, “venous”, and provisions re maintenance of comprehensive records and establishment of lead assessment and screening guidelines, and made technical and conforming changes.

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Sec. 19a-111a. Lead poisoning prevention program. Lead state agency. (a) The Department of Public Health shall be the lead state agency for lead poisoning prevention and control in this state. The Commissioner of Public Health shall (1) identify the state and local agencies in this state with responsibilities related to lead poisoning prevention, and (2) schedule a meeting of such state agencies and representative local agencies at least once annually in order to coordinate lead poisoning prevention efforts in this state.

(b) The commissioner shall establish, in consultation with recognized professional medical groups, guidelines consistent with the National Centers for Disease Control and Prevention's guidelines for assessment of the risk of lead poisoning, screening for lead poisoning and treatment and follow-up care of individuals, including children with lead poisoning and persons who are pregnant or are planning to become pregnant.

(c) The commissioner shall establish a lead poisoning prevention program to provide screening, diagnosis, consultation, inspection and treatment services, including, but not limited to, the prevention and elimination of lead poisoning through research, abatement, education and epidemiological and clinical activities. Such program shall include, but need not be limited to, the screening services provided pursuant to section 19a-111g.

(d) Within available appropriations, the commissioner may contract with individuals, groups or agencies for the provision of necessary services and enter into assistance agreements with municipalities, cities, boroughs or district departments of health or special service districts for the development and implementation of comprehensive lead poisoning prevention programs consistent with the provisions of sections 19a-110 to 19a-111c, inclusive.

(e) The commissioner shall maintain comprehensive records of all reports submitted pursuant to sections 19a-110 and 19a-111. Such records shall be geographically indexed for the purpose of determining the location of areas of relatively high incidences of lead poisoning.

(P.A. 87-394, S. 3, 7; P.A. 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 03-252, S. 18; June Sp. Sess. P.A. 07-2, S. 47; P.A. 23-31, S. 32.)

History: P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 03-252 made a technical change in Subsec. (b); June Sp. Sess. P.A. 07-2 amended Subsec. (a) to designate Department of Public Health as lead state agency for lead poisoning prevention and establish duties as lead state agency, designated existing provisions re lead poisoning prevention program as new Subsec. (b) and expanded program to include lead screening services provided pursuant to Sec. 19a-111g and redesignated existing Subsec. (b) as Subsec. (c); P.A. 23-31 amended Subsec. (a) by adding “and control”, added new Subsec. (b) re establishment of guidelines for lead assessment and screening, redesignated existing Subsecs. (b) and (c) as Subsecs. (c) and (d), and added Subsec. (e) re maintenance of comprehensive records.

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Sec. 19a-111b. Educational and publicity program. Early diagnosis program. Program for detection of sources of lead poisoning. Within the lead poisoning prevention program established pursuant to section 19a-111a:

(1) The commissioner shall institute an educational and publicity program in order to inform the general public, teachers, social workers and other human services personnel; residential property owners, and in particular, those that own buildings constructed prior to 1978; and health care providers of the danger, frequency and sources of lead poisoning and methods of preventing such poisoning;

(2) The commissioner shall establish an early diagnosis program to detect cases of lead poisoning. Such program shall include, but not be limited to, the routine examination of children under the age of six in accordance with protocols promulgated by the National Centers for Disease Control. Results equal to or greater than the levels specified in section 19a-110 from any examination pursuant to sections 19a-110 to 19a-111c, inclusive, shall be provided to the child's parent or legal guardian, the local director of health and the commissioner; and

(3) The commissioner shall establish a program for the detection of sources of lead poisoning. Within available appropriations, such program shall include the identification of dwellings in which paint, plaster or other accessible substances contain toxic levels of lead and the inspection of areas surrounding such dwellings for lead-containing materials. Any person who detects a toxic level of lead, as defined by the commissioner, shall report such findings to the commissioner. The commissioner shall inform all interested parties, including but not limited to, the owner of the building, the occupants of the building, enforcement officials and other necessary parties.

(P.A. 87-394, S. 4, 7; P.A. 03-252, S. 19; P.A. 23-31, S. 33.)

History: P.A. 03-252 made a technical change in Subdiv. (2); P.A. 23-31 amended Subdiv. (1) by adding “those that own”, replacing “1950” with “1978” and “services personnel” with “care providers”, and making a technical change.

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Sec. 19a-111c. Abatement of lead in dwellings. List of encapsulant products. Regulations. (a) The owner of any dwelling in which the paint, plaster or other material is found to contain toxic levels of lead and in which children under the age of six reside, shall remediate such toxic levels of lead through testing, abatement or management of such materials consistent with regulations adopted pursuant to this section. The Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, to establish requirements and procedures for testing, abatement and management of materials containing toxic levels of lead.

(b) The commissioner shall authorize the use of any liquid, cementitious or flexible lead encapsulant product which complies with an appropriate standard for such products developed by the American Society for Testing and Materials or similar testing organization acceptable to the commissioner for the abatement and remediation of lead hazards. The commissioner shall maintain a list of all such approved lead encapsulant products that may be used in this state for the remediation of lead hazards.

(c) (1) The Commissioner of Public Health may adopt regulations, in accordance with chapter 54, to regulate paint removal from the exterior of any building or structure where the paint removal project may present a health hazard related to lead exposure to neighboring premises. The regulations may establish: (A) Definitions, (B) applicability and exemption criteria, (C) procedures for submission of notifications, (D) appropriate work practices, and (E) penalties for noncompliance.

(2) The Commissioner of Public Health may adopt regulations, in accordance with chapter 54, to regulate the standards and procedures for remediation of lead hazards, including testing, abatement and management of materials containing toxic levels of lead in any premises.

(3) The commissioner may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulations, provided the department posts such policies and procedures on the eRegulations System prior to adopting them. Policies and procedures implemented pursuant to this section shall be valid until final regulations are adopted in accordance with the provisions of chapter 54.

(P.A. 87-394, S. 5, 7; P.A. 93-321, S. 3, 6; P.A. 95-204, S. 1, 2; 95-257, S. 12, 21, 58; June sp. Sess. P.A. 07-2, S. 54; P.A. 23-31, S. 34.)

History: P.A. 93-321 replaced requirement that dangerous materials be removed or covered with requirement that building owner “abate or manage” such materials “consistent with regulations adopted pursuant to this section”; P.A. 95-204 required the commissioner to authorize use of and keep a list of lead encapsulant products, effective June 28, 1995; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; June Sp. Sess. P.A. 07-2 designated provisions re owner's duty to abate and corresponding regulations as Subsec. (a) and expanded owner's duty to include remediation of dangerous materials, expanded scope of regulations to include requirements and procedures for testing, remediation and management of dangerous materials and defined “remediation”, designated provisions re approved lead encapsulant products as Subsec. (b) and added references to remediation of lead hazards therein and added Subsec. (c) authorizing Commissioner of Public Health to adopt regulations re paint removal from building exteriors and standards and procedures for testing, remediation, abatement and management of materials containing toxic levels of lead in any premises; P.A. 23-31 amended Subsec. (a) by replacing “abate, remediate or manage such dangerous” with “remediate such toxic levels of lead through testing, abatement or management of such” and “testing, remediation, abatement and management of materials” with “testing, abatement and management of materials” and deleting provision defining “remediation”, amended Subsec. (b) by replacing “abatement and remediation of lead hazards” with “remediation of lead hazards”, amended Subsec. (c)(1) by adding “related to lead exposure”, amended Subsec. (c)(2) by replacing “testing, remediation, as defined in this section” with “remediation of lead hazards, including testing”, and added Subsec. (c)(3) re implementation of policies and procedures.

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Sec. 19a-111g. Pediatric lead testing and risk assessment. Exemption. Prenatal guidance. Local health director epidemiological investigations. (a)(1) Each primary care provider giving pediatric care in this state, excluding a hospital emergency department and its staff shall conduct lead risk assessment and lead testing that includes, but need not be limited to:

(A) A complete medical risk assessment based on guidelines prescribed by the commissioner for each child from birth to six years of age, conducted at least annually;

(B) An annual lead screening test for each child who has an elevated risk of lead exposure based on findings of the medical risk assessment conducted pursuant to subparagraph (A) of this subdivision;

(D) Follow-up testing, in accordance with a schedule established by the commissioner, for each child with a confirmed blood lead level equal to or greater than three and one-half micrograms per deciliter.

(2) Each primary care provider giving pediatric care in this state, excluding a hospital emergency department and its staff, shall provide educational materials and guidance information concerning lead poisoning prevention to each child's parent or guardian in accordance with the commissioner's recommendations for childhood lead screening.

(3) The requirements of this subsection shall not apply to any child whose parents or guardians object to blood testing as being in conflict with their religious tenets and practice.

(b) Each prenatal health care provider shall (1) provide each pregnant person anticipatory guidance on lead poisoning prevention during pregnancy, (2) assess each pregnant person at the initial prenatal visit for lead exposure using a risk assessment tool recommended by the commissioner, (3) screen or refer for blood lead screening each pregnant person found to be at risk for lead exposure, (4) notify the local health director serving the jurisdiction in which the pregnant person resides if such person has a blood lead level equal to or greater than three and one-half micrograms per deciliter, and (5) provide anticipatory guidance regarding the prevention of childhood lead poisoning to each patient at such patient's postpartum visit.

(c) Upon the receipt of any notice provided pursuant to subdivision (4) of subsection (b) of this section, a local health director shall conduct the epidemiological investigation and take such other actions as described in section 19a-111.

(June Sp. Sess. P.A. 07-2, S. 48; P.A. 14-231, S. 9; P.A. 22-49, S. 3; 22-118, S. 151; P.A. 23-31, S. 35.)

History: June Sp. Sess. P.A. 07-2 effective January 1, 2009; P.A. 14-231 amended Subsec. (a) by replacing “screening” with “testing” and making a conforming change, adding new Subdiv. (3) re educational materials and anticipatory guidance information, redesignating existing Subdiv. (3) re medical risk assessment as Subdiv. (4) and amending same by replacing “seventy-one” with “seventy-two”, and redesignating existing Subdiv. (4) as Subdiv. (5); P.A. 22-49 amended Subsec. (a) by replacing reference to “Childhood Lead Poisoning Prevention Screening Advisory Committee” with “Advisory Committee on Childhood Lead Poisoning Prevention” in Subdiv. (1), adding new Subdiv. (2) re annual lead testing for a child 36 to 72 months of age determined to be at an elevated risk of lead exposure and redesignating existing Subdivs. (2) to (5) as Subdivs. (3) to (6), effective January 1, 2023; P.A. 22-118 made identical changes as P.A. 22-49, effective January 1, 2023; P.A. 23-31 amended Subsec. (a) by deleting Subdivs. (1) to (6) re pediatric lead testing criteria, adding new Subdiv. (1) re lead risk assessment and lead testing program, adding new Subdiv. (2) re educational materials and guidance information, redesignated existing Subsec. (b) as Subsec. (a)(3) and made a technical change in same, added new Subsec. (b) re requirements of prenatal health care providers, and added Subsec. (c) re local health director epidemiological investigation, effective January 1, 2024.

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Sec. 19a-111h. Review of lead poisoning data. Regulations. Section 19a-111h is repealed, effective October 1, 2023.

(June Sp. Sess. P.A. 07-2, S. 53; P.A. 23-31, S. 52.)

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Sec. 19a-111i. Report re lead poisoning prevention efforts. (a) On or before October 1, 2023, and annually thereafter, the Commissioner of Public Health shall report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and human services on the status of lead poisoning prevention and control efforts in the state for the preceding calendar year. Such report shall include, but need not be limited to, (1) the number of lead screenings of children, (2) the number of children diagnosed with elevated blood levels, and (3) the amount of testing, abatement and management of materials containing toxic levels of lead in all premises.

(b) On or before January 1, 2011, the Commissioner of Public Health shall (1) evaluate the lead screening and risk assessment conducted pursuant to sections 19a-110 and 19a-111g, and (2) report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and human services on the effectiveness of such screening and assessment, including a recommendation as to whether such screening and assessment should be continued as specified in sections 19a-110 and 19a-111g.

(June Sp. Sess. P.A. 07-2, S. 58; P.A. 17-146, S. 28; P.A. 23-31, S. 36.)

History: P.A. 17-146 amended Subsec. (a) by replacing “January 1, 2009” with “October 1, 2017”, effective June 30, 2017; P.A. 23-31 amended Subsec. (a) by replacing “October 1, 2017” with “October 1, 2023” and “lead poisoning prevention efforts” with “lead poisoning prevention and control efforts”, adding “for the preceding calendar year”, adding “lead screenings of” and deleting “screened for lead poisoning during the preceding calendar year” in Subdiv. (1), deleting “during the preceding calendar year” in Subdiv. (2), replacing “testing, remediation, abatement and management of materials” with “testing, abatement and management of materials” and deleting “during the preceding calendar year” in Subdiv. (3), and making a technical change, and amended Subsec. (b) by making a technical change, effective June 7, 2023.

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Sec. 19a-111j. Financial assistance to local health departments for lead poisoning prevention and control. (a) The Department of Public Health shall, within available appropriations, establish and administer a program of financial assistance to local health departments for expenses incurred in complying with this section and the applicable provisions of sections 19a-110, 19a-111a, 19a-206, 47a-52 and 47a-54f. Local health departments shall use the funds disbursed through the program for lead poisoning prevention and control services as described in subsection (b) of this section and other lead poisoning prevention and control purposes approved by the Department of Public Health.

(b) To be eligible to receive program funding from the Department of Public Health, a local health department shall administer a local lead poisoning prevention and control program approved by the department. Such program shall include, but need not be limited to: (1) Case management services; (2) lead poisoning educational services; (3) environmental health services; (4) health education services, including, but not limited to, education concerning proper nutrition for good health and the prevention of lead poisoning; and (5) participation in the Department of Public Health's system for the collection, tabulation, analysis and reporting of lead poisoning prevention and control statistics.

(c) A local health department may directly provide lead poisoning prevention and control services within its geographic coverage area or may contract for the provision of such services. A local health department's case management services shall include medical, behavioral, epidemiological and environmental intervention strategies for each child having a blood lead level that is equal to, or greater than, three and one-half micrograms of lead per deciliter of blood. A local health department shall initiate case management services for such child not later than five business days after the local health department receives the results of a test confirming that the child has a blood lead level as described in this subsection.

(d) A local health department's educational services shall include the distribution of educational materials concerning lead poisoning prevention to the parent, legal guardian and the appropriate health care provider for each child with a blood lead level equal to, or greater than, three and one-half micrograms of lead per deciliter of blood. Such educational materials shall be provided in English, Spanish and any other language common to the persons in the local health department's jurisdiction.

(e) The Department of Public Health shall disburse program funds to the local health department on an annual basis. After approving a local health department's application for program funding, the funding period shall begin on July first each year. The amount of such funding shall be determined by the Department of Public Health based on the number of confirmed childhood lead poisoning cases reported in the local health department's geographic coverage area during the previous calendar year. The director of any local health department that applies for program funding shall submit, not later than September thirtieth, annually, to the Department of Public Health a report concerning the local health department's lead poisoning and prevention control program. Such report shall contain: (1) A proposed budget for the expenditure of program funds for the new fiscal year; (2) a summary of planned program activities for the new fiscal year; and (3) a summary of program expenditures, services provided and operational activities during the previous fiscal year. The Department of Public Health shall approve a local health department's proposed budget prior to disbursing program funds to the local health department.

(June Sp. Sess. P.A. 07-2, S. 59; P.A. 12-202, S. 1; P.A. 23-31, S. 37.)

History: June Sp. Sess. P.A. 07-2 effective July 1, 2007; P.A. 12-202 designated existing provisions as Subsec. (a) and amended same to add reference to compliance with “this section” re expenses incurred, delete provision re adoption of regulations and add provision re use of funds by local health departments and added Subsec. (b) re requirements for funding eligibility, Subsec. (c) re prevention and control services and case management services, Subsec. (d) re educational services and Subsec. (e) re disbursement of program funds to and reports by local health departments; P.A. 23-31 amended Subsec. (c) by replacing “one confirmed blood level” with “a blood level” and “twenty” with “three and one-half”, and deleting provision re case management services to include strategies for each child having 2 confirmed blood levels that are equal to, or greater than, 15 micrograms of lead but less than 20 micrograms of lead per deciliter of blood, and amended Subsec. (d) by replacing “confirmed blood lead level” with “blood lead level” and “ten” with “three and one-half” and adding provision re multilingual educational materials.

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Sec. 19a-111m. Evaluation of information or guidance regarding mold and development of uniform standards for identifying, assessing and remediating mold and guidelines for limiting exposure to mold. Public awareness campaign concerning mold in residential housing. Not later than January 1, 2024, the Department of Public Health shall (1) evaluate information or guidance published by the United States Environmental Protection Agency regarding identification of, assessment of, remediation of and limiting of exposure to mold; (2) develop the following: (A) Uniform standards for identifying and assessing mold in residential housing, (B) uniform standards for remediating mold, including, but not limited to, any necessary revisions to the guidelines establishing mold abatement protocols published by the department pursuant to section 19a-111l, and (C) guidelines for limiting exposure to mold in residential housing and uniform standards for assessing the health threat from such exposure, including, but not limited to, its effects on indoor air quality; (3) publish such standards and guidelines on the department's Internet web site; and (4) develop a public awareness campaign concerning mold in residential housing, including, but not limited to, public service announcements on the department's Internet web site and social media accounts regarding (A) mold prevention and identification in the home, and (B) the health risks associated with exposure to mold in the home.

(P.A. 23-42, S. 1.)

History: P.A. 23-42 effective July 1, 2023.

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Sec. 19a-112h. State-wide human immunodeficiency virus pre-exposure and post-exposure prophylaxis drug assistance program. Regulations. (a) The Commissioner of Public Health shall establish and contract for the administration of a state-wide human immunodeficiency virus pre-exposure prophylaxis and post-exposure prophylaxis drug assistance program using appropriated AIDS Services funding, provided such funding is equal to or greater than twenty-five thousand dollars annually. The program shall provide financial assistance to individuals at risk of acquiring human immunodeficiency for the purchase of pre-exposure and post-exposure prophylaxis for human immunodeficiency virus prescribed by a licensed physician consistent with the recommendations of the National Centers for Disease Control and Prevention. For the purposes of this subsection, “financial assistance” includes, but need not be limited to, payments for out-of-pocket costs, copayments, coinsurance, and up to full cost payments toward a deductible for individuals who are underinsured and for whom the program is the payer of last resort.

(b) The commissioner shall give priority for benefits under the program established pursuant to this section to individuals who have an increased risk of acquiring human immunodeficiency virus or who have had a recent exposure to such virus, but are unable to purchase pre-exposure and post-exposure prophylaxis for human immunodeficiency virus and for whom the program is a payer of last resort.

(c) The commissioner may adopt regulations in accordance with the provisions of chapter 54 to implement the provisions of this section. The commissioner may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulations, provided notice of intent to adopt regulations is published on the eRegulations System not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.

(P.A. 11-44, S. 173; P.A. 23-19, S. 17.)

History: P.A. 11-44 effective July 1, 2011; P.A. 23-19 designated existing provisions as Subsec. (a), substantially amended Subsec. (a) by substituting state-wide human immunodeficiency virus pre-exposure and post-exposure prophylaxis drug assistance program for financial assistance program for victims of sexual assault, and added Subsec. (b) re priority for benefits under program and Subsec. (c) re regulations, policies and procedures, effective June 7, 2023.

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Sec. 19a-112j. Commission on Community Gun Violence Intervention and Prevention. Duties. Membership. Report. (a) There is established a Commission on Community Gun Violence Intervention and Prevention to advise the Commissioner of Public Health on the development of evidence-based, evidenced-informed, community-centric gun programs and strategies to reduce community gun violence in the state. The commission shall be within the Department of Public Health for administrative purposes only.

(b) The commission shall be composed of the following members:

(1) Two appointed by the speaker of the House of Representatives, one of whom shall be a representative of the Connecticut Hospital Association and one of whom shall be a representative of Compass Youth Collaborative;

(2) Two appointed by the president pro tempore of the Senate, one of whom shall be a representative of the Connecticut Violence Intervention Program and one of whom shall be a representative of the Regional Youth Adult Social Action Partnership;

(3) Two appointed by the majority leader of the House of Representatives, one of whom shall be a representative of Hartford Communities That Care, Inc. and one of whom shall be a representative of CT Against Gun Violence;

(4) Two appointed by the majority leader of the Senate, one of whom shall be a representative of Project Longevity and one of whom shall be a representative of Saint Francis Hospital and Medical Center;

(5) One appointed by the minority leader of the House of Representatives, who shall be a representative of Yale New Haven Hospital;

(6) One appointed by the minority leader of the Senate, who shall be a representative of Hartford Hospital;

(7) One appointed by the House chairperson of the joint standing committee of the General Assembly having cognizance of matters relating to public health, who shall be a representative of the Greater Bridgeport Area Prevention Program;

(8) One appointed by the Senate chairperson of the joint standing committee of the General Assembly having cognizance of matters relating to public health, who shall be a representative of a community gun violence reduction program;

(9) One appointed by the executive director of the Commission on Women, Children, Seniors, Equity and Opportunity, who shall be a representative of the Health Alliance for Violence Intervention;

(10) Two appointed by the Commissioner of Public Health;

(11) Two appointed by the Governor, one of whom shall be a member of the faculty at an academic institution and have experience in gun violence prevention and one of whom is an advocate for survivors of violent crime;

(12) One appointed by the minority leader of the House of Representatives, who shall be employed as the highest-ranking professional police officer of an organized police department of a municipality within the state;

(13) One appointed by the minority leader of the Senate, who shall be a youth representative of a group that advocates on behalf of justice-involved youth;

(14) The Commissioner of Public Health;

(15) The Commissioner of Children and Families, or the commissioner's designee;

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

(17) The Commissioner of Education, or the commissioner's designee;

(18) The executive director of the Commission on Women, Children, Seniors, Equity and Opportunity, or the executive director's designee;

(19) One appointed by the House ranking member of the joint standing committee of the General Assembly having cognizance of matters relating to public health, who shall be a municipal police chief; and

(20) One appointed by the Senate ranking member of the joint standing committee of the General Assembly having cognizance of matters relating to public health, who shall be a local director of health.

(c) The members of the community gun violence intervention and prevention advisory committee established under section 9 of public act 21-35* shall be deemed the initial appointments to the commission under subdivisions (1) to (10), inclusive, of subsection (b) of this section.

(d) In making appointments to the commission, the appointing authorities shall seek to select individuals for such appointments who are representative of the full geographic diversity of communities that experience community gun violence in the state.

(e) The first meeting of the commission shall be held not later than sixty days after May 7, 2022. The Commissioner of Public Health shall serve as the chairperson of the commission.

(f) A majority of the membership of the commission shall constitute a quorum for the transaction of any business and any decision shall be by a majority vote of those present at a meeting, except the commission may establish such subcommissions, advisory groups or other entities as it deems necessary to further the purposes of the commission, including, but not limited to, a subcommission, advisory group or other entity to evaluate the challenges associated with the provision of home health care to victims of gun violence and methods to foster a system that unites community service providers with adults and juveniles needing supports and services in order to address trauma suffered as a result of gun violence.

(g) The members of the commission shall serve without compensation, but shall, within the limits of available funds, be reimbursed for expenses necessarily incurred in the performance of their duties.

(h) The commission shall advise the Department of Public Health regarding the development of criteria for any grant opportunities that arise through the program established pursuant to section 19a-112i.

(i) Not later than January 1, 2023, and annually thereafter, the commission shall submit a report 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, and to the Commissioner of Public Health concerning the activities of the commission.

(P.A. 22-118, S. 81; P.A. 23-31, S. 13; 23-97, S. 24.)

*Note: Section 9 of public act 21-35 is special in nature and therefore has not been codified but remains in full force and effect according to its terms.

History: P.A. 22-118 effective May 7, 2022; P.A. 23-31 amended Subsec. (b) by adding new Subdiv. (17) re membership of Commissioner of Education, or commissioner's designee, redesignating existing Subdiv. (17) as Subdiv. (18), adding Subdiv. (19) re appointment by House ranking member of joint standing committee on public health, adding Subdiv. (20) re appointment by Senate ranking member of joint standing committee on public health, and making conforming changes, effective June 7, 2023; P.A. 23-97 amended Subsec. (f) by allowing the commission to establish subcommissions, advisory groups and other entities to evaluate challenges in provision of home health care to victims of gun violence, effective July 1, 2023; (Revisor's note: In 2024, a reference to “the effective date of this section” in Subsec. (e) was changed editorially by the Revisors to “May 7, 2022” for accuracy).

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Sec. 19a-122d. Hospice Hospital at Home pilot program. (a) As used in this section:

(1) “Telehealth” means the mode of delivering health care or other health services via information and communication technologies to facilitate the diagnosis, consultation and treatment, education, care management and self-management of a patient's physical and mental health, and includes (A) interaction between the patient at the originating site and the telehealth provider at a distant site, and (B) synchronous interactions, asynchronous store and forward transfers or remote patient monitoring. Telehealth does not include the use of facsimile, audio-only telephone, texting or electronic mail;

(2) “Physician” means a physician licensed pursuant to chapter 370;

(3) “Advanced practice registered nurse” means an advanced practice registered nurse licensed pursuant to chapter 378;

(4) “Registered nurse” means a registered nurse licensed pursuant to chapter 378; and

(5) “Personal emergency response system” means a twenty-four-hour-per-day electronic alarm system placed in a patient's home that enables the patient to obtain immediate help in case of an emergency.

(b) Not later than January 1, 2024, the Department of Public Health shall establish, in collaboration with a hospital in the state and the Department of Social Services, a Hospice Hospital at Home pilot program to provide hospice care to patients in the home through a combination of in-person visits and telehealth. The pilot program shall provide the following to such patients:

(1) A daily telehealth visit by a physician or an advanced practice registered nurse that the patient may attend using the patient's computer or mobile device or, if the patient does not have access to a computer or mobile device in the home, using a tablet provided through the program;

(2) In-person visits by a registered nurse at least twice daily, or more frequently if necessary, as determined by a physician or an advanced practice registered nurse treating the patient;

(3) A personal emergency response system;

(4) Remote monitoring of the patient by physicians, advanced practice registered nurses and registered nurses participating in the pilot program, provided the patient and each person residing with the patient consent to such monitoring; and

(5) Telephone access to an on-call physician or advanced practice registered nurse if the patient, the patient's caregiver or any person residing with the patient has any immediate questions or concerns regarding the patient's condition.

(P.A. 23-174, S. 1.)

History: P.A. 23-174 effective July 1, 2023.

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Sec. 19a-122e. Administration of fluids or medications intravenously by an advance practice registered nurse or registered nurse providing hospice care. (a) As used in this section:

(1) “Advanced practice registered nurse” means an advanced practice registered nurse licensed pursuant to chapter 378;

(2) “Registered nurse” means a registered nurse licensed pursuant to chapter 378;

(3) “Hospice care program” means a program to provide hospice services operated by an organization licensed by the Department of Public Health to provide hospice home care services pursuant to section 19a-122b;

(4) “Supervision” means the overseeing of the work of a registered nurse through the continuous availability of direct communication between the registered nurse and a licensed physician;

(5) “Physician” means a physician licensed pursuant to chapter 370;

(6) “Infusion” means the administration of intravenous fluid or medication given over a period of time; and

(7) “Intravenous push” means the administration of intravenous medication rapidly through an injection with a syringe in the intravenous line.

(b) An advanced practice registered nurse who is providing hospice care through a hospice care program may administer fluids or medications intravenously to a patient, including, but not limited to, by performing an infusion or an intravenous push. A registered nurse who is providing hospice care through a hospice care program may, under the supervision of a physician, administer fluids or medications intravenously to a patient, including, but not limited to, by performing an infusion or an intravenous push.

(P.A. 23-174, S. 2.)

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Sec. 19a-127l. Quality of care program. Quality of Care Advisory Committee. (a) There is established a quality of care program within the Department of Public Health. The Commissioner of Public Health shall develop for the purposes of said program (1) a standardized data set to measure the clinical performance of health care facilities, as defined in section 19a-630, and require such data to be collected and reported periodically to the department, including, but not limited to, data for the measurement of comparable patient satisfaction, and (2) methods to provide public accountability for health care delivery systems by such facilities. The commissioner shall develop such set and methods for health care facilities and may revise such sets and methods as necessary, as determined by the commissioner. The commissioner shall consult with an association of hospitals in the state on the scope and timing of the data reporting requirements described in this section to reduce the administrative burden on hospitals in producing and disclosing such data. Data collected pursuant to the provisions of this section shall not include personally identifiable information of patients.

(b) In carrying out its responsibilities under subsection (a) of this section, the department shall develop the following for the quality of care program:

(1) Comparable performance measures to be reported;

(2) Selection of patient satisfaction survey measures and instruments;

(3) Methods and format of standardized data collection;

(4) Format for a public quality performance measurement report;

(5) Human resources and quality measurements;

(6) Medical error reduction methods;

(7) Systems for sharing and implementing universally accepted best practices;

(8) Systems for reporting outcome data;

(9) Systems for continuum of care;

(10) Recommendations concerning the use of an ISO 9000 quality auditing program;

(11) Recommendations concerning the types of statutory protection needed prior to collecting any data or information under this section and sections 19a-127m and 19a-127n;

(12) Recommendations concerning the collection and analysis of data on patient malnutrition for the purposes of improving quality of care; and

(13) Any other issues that the department deems appropriate.

(c) (1) There is established a Quality of Care Advisory Committee which shall advise the Department of Public Health on the issues set forth in subdivisions (1) to (12), inclusive, of subsection (b) of this section. The advisory committee may meet at the discretion of the Commissioner of Public Health.

(2) Said committee shall create a standing subcommittee on best practices. The subcommittee shall (A) advise the department on effective methods for sharing with providers the quality improvement information learned from the department's review of reports and corrective action plans, including quality improvement practices, patient safety issues and preventative strategies, (B) not later than January 1, 2006, review and make recommendations concerning best practices with respect to when breast cancer screening should be conducted using comprehensive ultrasound screening or mammogram examinations, and (C) not later than January 1, 2008, study and make recommendations to the department concerning best practices with respect to communications between a patient's primary care provider and other providers involved in a patient's care, including hospitalists and specialists. The department shall, at least quarterly, disseminate information regarding quality improvement practices, patient safety issues and preventative strategies to the subcommittee and hospitals.

(d) The advisory committee shall consist of (1) four members who represent and shall be appointed by the Connecticut Hospital Association, including three members who represent three separate hospitals that are not affiliated of which one such hospital is an academic medical center; (2) one member who represents and shall be appointed by the Connecticut Nursing Association; (3) two members who represent and shall be appointed by the Connecticut Medical Society, including one member who is an active medical care provider; (4) two members who represent and shall be appointed by the Connecticut Business and Industry Association, including one member who represents a large business and one member who represents a small business; (5) one member who represents and shall be appointed by the Home Health Care Association; (6) one member who represents and shall be appointed by the Connecticut Association of Health Care Facilities; (7) one member who represents and shall be appointed by LeadingAge Connecticut, Inc.; (8) two members who represent and shall be appointed by the AFL-CIO; (9) one member who represents consumers of health care services and who shall be appointed by the Commissioner of Public Health; (10) one member who represents a school of public health and who shall be appointed by the Commissioner of Public Health; (11) the Commissioner of Public Health or said commissioner's designee; (12) the Commissioner of Social Services or said commissioner's designee; (13) the Secretary of the Office of Policy and Management or said secretary's designee; (14) two members who represent licensed health plans and shall be appointed by the Connecticut Association of Health Care Plans; (15) one member who represents and shall be appointed by the federally designated state peer review organization; and (16) one member who represents and shall be appointed by the Connecticut Pharmaceutical Association. The chairperson of the advisory committee shall be the Commissioner of Public Health or said commissioner's designee. The chairperson of the committee, with a vote of the majority of the members present, may appoint ex-officio nonvoting members in specialties not represented among voting members. Vacancies shall be filled by the person who makes the appointment under this subsection.

(e) The chairperson of the advisory committee may designate one or more working groups to address specific issues and shall appoint the members of each working group. Each working group shall report its findings and recommendations to the full advisory committee.

(f) The advisory committee shall establish methods for informing the public regarding access to the department's consumer and regulatory services.

(g) The Department of Public Health may seek out funding for the purpose of implementing the provisions of this section. Said provisions shall be implemented upon receipt of such funding.

(P.A. 02-125, S. 1; P.A. 04-164, S. 3; P.A. 05-167, S. 1; 05-272, S. 30; P.A. 06-195, S. 41; P.A. 08-184, S. 56; Sept. Sp. Sess. P.A. 09-3, S. 32; P.A. 10-122, S. 2; P.A. 12-197, S. 13; P.A. 17-146, S. 17; P.A. 18-168, S. 14; P.A. 19-157, S. 100; P.A. 23-31, S. 12.)

History: P.A. 04-164 amended Subsec. (c) by designating existing provisions as Subdiv. (1) and adding Subdiv. (2) re best practices subcommittee, effective July 1, 2004; P.A. 05-167 added new Subsec. (h) requiring advisory committee to examine, evaluate and report re data collection system for cardiac outcomes and redesignated existing Subsec. (h) as Subsec. (i), effective July 1, 2005; P.A. 05-272 amended Subsec. (c)(2) by designating existing provision re subcommittee duties as Subpara. (A) and adding Subpara. (B) requiring subcommittee to review and make recommendations concerning best practices re breast cancer screening; P.A. 06-195 amended Subsec. (c)(2) by adding Subpara. (C) re study and recommendations concerning best practices with respect to communications between the primary care provider and other providers involved in a patient's care; P.A. 08-184 amended Subsec. (c)(1) by substituting “semiannually” for “quarterly” re committee meeting, effective July 1, 2008; Sept. Sp. Sess. P.A. 09-3 amended Subsec. (d) by deleting former Subdiv. (11) re committee member appointed by Office of Health Care Access and redesignating existing Subdivs. (12) to (17) as Subdivs. (11) to (16), effective October 6, 2009; P.A. 10-122 added new Subsec. (i) re advisory committee's responsibility for establishing methods for informing public regarding department's consumer and regulatory services, redesignated existing Subsec. (i) as Subsec. (j) and made a technical change therein, effective July 1, 2010; P.A. 12-197 amended Subsec. (d)(7) by replacing reference to Connecticut Association of Not-For-Profit Providers for the Aging with reference to LeadingAge Connecticut, Inc; P.A. 17-146 amended Subsec. (c)(1) by replacing provision re advisory committee to meet at least semiannually with provision re advisory committee may meet at discretion of commissioner; P.A. 18-168 deleted Subsecs. (f) to (h) re reporting requirements and redesignated Subsecs. (i) and (j) as Subsecs. (f) and (g); P.A. 19-157 amended Subsec. (b) by adding new Subdiv. (12) re malnutrition data and redesignating existing Subdiv. (12) as Subdiv. (13), effective July 1, 2019; P.A. 23-31 amended Subsec. (a) by replacing references to department with references to Commissioner of Public Health, deleting provision re committee considering date set and accountability methods and recommending inclusion of other health care facilities in each subsequent year, and adding provisions allowing commissioner to revise sets and methods, requiring commissioner to consult with association of hospitals, and requiring data collection to not include personally identifiable information of patients, effective July 1, 2023.

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Sec. 19a-127n. Adverse events. Reporting requirements. Regulations. Confidentiality of reports. Retaliatory action prohibited. (a)(1) For purposes of this section, an “adverse event” means any event that is identified on the National Quality Forum's List of Serious Reportable Events or on a list compiled by the Commissioner of Public Health and adopted as regulations pursuant to subsection (c) of this section; and “corrective action plan” means a plan that (A) implements strategies that are reflective of evidenced-based best practices and that reduce the risk of similar adverse events occurring in the future, and (B) measures the effectiveness of such strategies by addressing the implementation, oversight and time lines of such strategies.

(2) The commissioner shall review the list of adverse events periodically, but not less than annually, to ascertain whether any additions, deletions or modifications to the list are necessary.

(b) On and after October 1, 2023, a hospital or birth center, as such terms are defined in section 19a-490, or outpatient surgical facility, as defined in section 19a-493b, shall report adverse events to the Department of Public Health on a form prescribed by the commissioner as follows: (1) A written report and the status of any corrective steps shall be submitted not later than seven days after the date on which the adverse event occurred; and (2) a corrective action plan shall be filed not later than thirty days after the date on which the adverse event occurred. Emergent reports, as defined in the regulations adopted pursuant to subsection (c) of this section, shall be made to the department immediately. Failure to implement a corrective action plan may result in disciplinary action by the commissioner, pursuant to section 19a-494.

(c) The commissioner shall adopt regulations, in accordance with chapter 54, to carry out the provisions of this section. Such regulations shall include, but shall not be limited to, a list of adverse events that are in addition to those contained in the National Quality Forum's List of Serious Reportable Events.

(d) On or before October first annually, the commissioner shall report, in accordance with the provisions of section 11-4a, on adverse event reporting, to the joint standing committee of the General Assembly having cognizance of matters relating to public health. For annual reports submitted on or after July 1, 2011, the commissioner shall include hospital and outpatient surgical facility adverse event information for each facility identified (1) by the National Quality Forum's List of Serious Reportable Events category, and (2) in accordance with any list compiled by the commissioner and adopted as regulations pursuant to subsection (c) of this section. Such reports shall be prepared in a format that uses relevant contextual information. For purposes of this subsection “contextual information” includes, but is not limited to, (A) the relationship between the number of adverse events and a hospital's total number of patient days or an outpatient surgical facility's total number of surgical encounters expressed as a fraction in which the numerator is the aggregate number of adverse events reported by each hospital or outpatient surgical facility by category as specified in this subsection and the denominator is the total of the hospital's patient days or the outpatient surgical facility's total number of surgical encounters, and (B) information concerning the patient population served by the hospital or outpatient surgical facility, including such hospital's or outpatient surgical facility's payor or case mix. In addition, a hospital or outpatient surgical facility may provide informational comments relating to any adverse event reported to the commissioner pursuant to this section. On and after July 1, 2011, any report submitted by the commissioner pursuant to this subsection shall include any informational comments received concerning an adverse event that is included in the report.

(e) Information collected pursuant to this section shall not be disclosed pursuant to subsection (a) of section 1-210 at any time, and information collected pursuant to this section shall not be subject to subpoena or discovery or introduced into evidence in any judicial or administrative proceeding except as otherwise specifically provided by law. Nothing in this section shall be construed to limit access to or disclosure of investigative files, including any adverse event report contained in such files, maintained by the department as otherwise provided in section 19a-499.

(f) If the department determines that it will initiate an investigation of an adverse event that has been reported, such investigation may include review by one or more practitioners with clinical expertise of the type involved in the reported adverse event.

(g) No hospital or outpatient surgical facility shall discharge, refuse to hire, refuse to serve, retaliate in any manner or take any adverse action against any employee, applicant for employment or health care provider because such employee, applicant for employment or health care provider takes or has taken any action in furtherance of the enforcement of the provisions of this section.

(P.A. 02-125, S. 3; P.A. 03-278, S. 123; P.A. 04-164, S. 1; P.A. 06-195, S. 25, 26; P.A. 10-122, S. 1; P.A. 23-147, S. 6.)

History: P.A. 02-125 effective July 1, 2002; P.A. 03-278 made a technical change in Subsec. (c), effective July 9, 2003; P.A. 04-164 amended Subsec. (a) by redefining “adverse event”, defining “corrective action plan” and requiring periodic review of list of adverse events, deleted former Subsec. (b) re classes of adverse events, redesignated existing Subsec. (c) as new Subsec. (b) and changed timing of required reports from 72 hours to 7 days and of corrective plans from 7 days to 30 days, but required immediate submittal of emergent reports, deleted former Subsec. (d) re corrective plans, redesignated existing Subsecs. (e) to (g) and (h) as new Subsecs. (c) to (e) and (g), respectively, changed reporting date in new Subsec. (d) from March first to October first, added provision in new Subsec. (e) re access to or disclosure of investigative files, added new Subsec. (f) re investigation of adverse event, and made technical and conforming changes throughout, effective July 1, 2004; P.A. 06-195 amended Subsec. (b) by requiring adverse event reports to be submitted on form prescribed by Commissioner of Public Health and making a technical change and amended Subsec. (c) by deleting provisions requiring prescribed form for reporting adverse events to be adopted by regulation; P.A. 10-122 amended Subsec. (a)(1) by redefining “corrective action plan” and making technical changes, amended Subsecs. (b) and (c) by making technical changes, amended Subsec. (d) by adding provisions re content and format of reports submitted by commissioner on or after July 1, 2011, and requiring that reports include hospital and outpatient surgical facility adverse event information for each facility and amended Subsec. (g) by replacing former provision re Quality of Care Advisory Committee with provision prohibiting retaliatory actions by hospital or outpatient surgical facility, effective July 1, 2010; P.A. 23-147 amended Subsec. (b) by replacing “October 1, 2002” with “October 1, 2023”, adding reference to birth center and adding provision re definition of outpatient surgical facility.

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Sec. 19a-131m. Pandemic preparedness report. Not later than January 1, 2024, and annually thereafter, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies on the state's pandemic preparedness.

(P.A. 23-204, S. 62.)

History: P.A. 23-204 effective July 1, 2023.

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Sec. 19a-132. Transferred to Chapter 814g, Sec. 46a-175.

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Sec. 19a-133a. Commission on Racial Equity in Public Health. Membership of advisory body. (a) There is established a Commission on Racial Equity in Public Health, to document and make recommendations to decrease the effect of racism on public health. The commission shall be part of the Legislative Department.

(b) The commission shall have an advisory body that shall consist of the following members:

(1) Three appointed by the speaker of the House of Representatives, one of whom shall be a representative of a nonprofit organization that focuses on health policy and racial equity issues and shall serve as cochairperson of the advisory body, one of whom shall be a representative of a nonprofit organization that focuses on racial equity and community engagement and one of whom shall be an expert in immigration policy and law;

(2) Three appointed by the president pro tempore of the Senate, one of whom shall be a health disparities expert affiliated with an academic research institution and shall serve as cochairperson of the advisory board, one of whom shall be a representative of a violence intervention program using a health-based approach to examine individuals post-incarceration and policies for integration and one of whom shall be a representative of a philanthropic entity that focuses on racial equity;

(3) Two appointed by the majority leader of the House of Representatives, one of whom shall be a representative of a nonpartisan criminal justice policy and research entity and one of whom shall be a biostatistician or epidemiologist with knowledge of the effects of social-structural factors on health;

(4) Two appointed by the majority leader of the Senate, one of whom shall be a representative of a nonprofit that focuses on equitable housing policy and one of whom shall be a medical professional with expertise in diversity, equity and inclusion policy;

(5) Two appointed by the minority leader of the House of Representatives, one of whom shall be an expert in environmental impacts on human health who is affiliated with an academic institution and one of whom shall be a representative of a nonprofit that focuses on economic research and policy;

(6) Two appointed by the minority leader of the Senate, one of whom shall be a public health educator or researcher affiliated with an academic institution and one of whom shall be a current or former educator, school counselor or school nurse with public policy experience; and

(7) One appointed by the chairperson of the Black and Puerto Rican Caucus who shall be an education policy researcher affiliated with an academic research institution.

(c) Any member of the advisory body appointed under subdivisions (1) to (7), inclusive, of subsection (b) of this section may be a member of the General Assembly. All initial appointments to the advisory body made under subdivisions (1) to (7), inclusive, of subsection (b) of this section shall be made not later than sixty days after June 14, 2021. Appointed members shall serve a term that is coterminous with the appointing official and may serve more than one term.

(d) The cochairpersons of the advisory body shall schedule the first meeting of the advisory body, which shall be held not later than sixty days after June 12, 2023. If appointments under subsection (b) of this section are not made within such sixty-day period, the chairpersons may designate individuals with the required qualifications stated for the applicable appointment to serve on the commission until appointments are made pursuant to subsection (b) of this section.

(e) Members shall continue to serve until their successors are appointed. Any vacancy shall be filled by the appointing authority. Any vacancy occurring other than by expiration of term shall be filled for the balance of the unexpired term.

(f) A majority of the membership shall constitute a quorum for the transaction of any business and any decision shall be by a majority vote of those present at a meeting, except the commission may establish such committees, subcommittees or other entities as it deems necessary to further the purposes of the commission. The advisory body may adopt rules of procedure.

(g) The members of the advisory body shall serve without compensation, but shall, within the limits of available funds, be reimbursed for expenses necessarily incurred in the performance of their duties.

(h) The advisory body, by majority vote, shall confirm the hire of an executive director of the commission.

(i) The commission shall have the following powers and duties: To (1) support collaboration by bringing together partners from many different sectors to recognize the links between health and other issues and policy areas and build new partnerships to promote health and equity and increase government efficiency; (2) create a comprehensive strategic plan to eliminate health disparities and inequities across sectors, in accordance with section 19a-133b; (3) study the impact that the public health crisis of racism has on vulnerable populations within diverse groups of the state population, including on the basis of race, ethnicity, sexual orientation, gender identity and disability, including, but not limited to, Black American descendants of slavery; (4) obtain from any legislative or executive department, board, commission or other agency of the state or any organization or other entity such assistance as necessary and available to carry out the purposes of this section; (5) accept any gift, donation or bequest for the purpose of performing the duties described in this section; (6) establish bylaws to govern its procedures; and (7) perform such other acts as may be necessary and appropriate to carry out the duties described in this section, including, but not limited to, the creation of subcommittees.

(j) The commission shall engage with a diverse range of community members, including people of color who identify as members of diverse groups of the state population, including on the basis of race, ethnicity, sexual orientation, gender identity and disability, who experience inequities in health, to make recommendations to the relevant state agencies or other entities on an ongoing basis concerning the following: (1) Structural racism in the state's laws and regulations impacting public health, where, as used in this subdivision, “structural racism” means a system that structures opportunity and assigns value in a way that disproportionally and negatively impacts Black, Indigenous, Latino or Asian people or other people of color; (2) racial disparities in the state's criminal justice system and its impact on the health and well-being of individuals and families, including overall health outcomes and rates of depression, suicide, substance use disorder and chronic disease; (3) racial disparities in access to the resources necessary for healthy living, including, but not limited to, access to adequate fresh food and physical activity, public safety and the decrease of pollution in communities; (4) racial disparities in health outcomes; (5) the impact of zoning restrictions on the creation of housing disparities and such disparities' impact on public health; (6) racial disparities in state hiring and contracting processes; and (7) any suggestions to reduce the impact of the public health crisis of racism within the vulnerable populations studied under subdivision (3) of subsection (i) of this section.

(k) Not later than January 1, 2022, and every six months thereafter, the commission shall submit a report to the Secretary of the Office of Policy and Management and the joint standing committees of the General Assembly having cognizance of matters relating to public health and appropriations and the budgets of state agencies, in accordance with the provisions of section 11-4a, concerning (1) the activities of the commission during the prior six-month period; (2) any progress made in attaining the goal described in subsection (c) of section 19a-133b; (3) any recommended changes to such goal based on the research conducted by the commission, any disparity study performed by any state agency or entity, or any community input received; (4) the status of the comprehensive strategic plan required under section 19a-133b; and (5) any recommendations for policy changes or amendments to state law.

(P.A. 21-35, S. 2; P.A. 22-92, S. 15; P.A. 23-204, S. 188.)

History: P.A. 21-35 effective June 14, 2021; P.A. 22-92 amended Subsec. (b)(6) by making a technical change, effective May 24, 2022;P.A. 23-204 amended Subsec. (b) by adding reference to an advisory body and substantially revising membership, amended Subsec. (c) by replacing references to “commission” with “advisory body” and making technical changes, amended Subsec. (d) by replacing references to the Secretary of the Office of Policy and Management and “representative appointed under subdivision (1)” with “cochairpersons”, replacing “commission” with “advisory body” and replacing “June 14, 2021” with “June 12, 2023”, amended Subsecs. (f) to (h) by replacing “commission” with “advisory body”, and further amended Subsec. (h) by replacing “hire” with “confirm the hire of”, and deleting reference to serving as administrative staff and provisions re serving at pleasure of the commission, requesting assistance in hiring executive director and hiring executive assistants, effective June 12, 2023.

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Sec. 19a-133b. Commission on Racial Equity in Public Health. Strategic plan re elimination of health disparities and inequities. (a) The Commission on Racial Equity in Public Health, established under section 19a-133a, shall develop and periodically update a comprehensive strategic plan to eliminate health disparities and inequities across sectors, including consideration of the following: Air and water quality, natural resources and agricultural land, affordable housing, infrastructure systems, public health, access to quality health care, social services, sustainable communities and the impact of climate change.

(b) Such plan shall address the incorporation of health and equity into specific policies, programs and government decision-making processes including, but not limited to, the following: (1) Disparities in laws and regulations impacting public health; (2) disparities in the criminal justice system; (3) disparities in access to resources, including, but not limited to, healthy food, safe housing, public safety and environments free of excess pollution; and (4) disparities in access to quality health care.

(c) Not later than January 1, 2024, as part of such plan, the commission shall report, using available scientifically based measurements, the rates of disparity in the state based on race and ethnicity, in the following areas: (1) Education indicators, including kindergarten entry inventory, third grade reading proficiency, scores on the mastery examination, administered pursuant to section 10-14n, rates of school-based discipline, high school graduation rates and retention rates after the first year of study for institutions of higher education in the state, as defined in section 3-22a; (2) health care utilization and outcome indicators, including health insurance coverage rates, pregnancy and infant health outcomes, emergency room visits and deaths related to conditions associated with exposure to environmental pollutants, including respiratory ailments, quality of life, life expectancy, lead poisoning and access to adequate healthy nutrition and self-reported well-being surveys; (3) criminal justice indicators, including rates of involvement with the justice system; and (4) economic indicators, including rates of poverty, income and housing insecurity. It shall be the goal of the state to attain at least a seventy per cent reduction in the racial inequities set forth in subdivisions (1) to (4), inclusive, of this subsection from the rates of disparities determined by the commission on or before January 1, 2024.

(d) Upon completion of the initial comprehensive strategic plan, and thereafter of any update to such plan, the commission shall submit the plan 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, and to any other joint standing committee of the General Assembly having cognizance of matters relevant to what is contained in such plan, as determined by the commission.

(P.A. 21-35, S. 3; P.A. 23-204, S. 189.)

History: P.A. 21-35 effective June 14, 2021; P.A. 23-204 amended Subsec. (c) by replacing references to “2022” with “2024”, “determine” with “report”, “percentages” with “rates”, “readiness” with “entry inventory” and “disparities” with “inequities” and inserting “and ethnicity” after “race”, effective June 12, 2023.

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Sec. 19a-133c. Commission on Racial Equity in Public Health. Best practices for state agencies re structural racism. (a) As used in this section, “structural racism” means a system that structures opportunity and assigns value in a way that disproportionally and negatively impacts Black, Indigenous, Latino or Asian people or other people of color, and “state agency” has the same meaning as provided in section 1-79. The Commission on Racial Equity in Public Health, established under section 19a-133a, shall recommend best practices for state agencies to (1) evaluate structural racism within their own policies, practices, and operations, and (2) create and implement a plan, which includes the establishment of benchmarks for improvement, to ultimately eliminate any such structural racism within the agency.

(b) Not later than January 1, 2024, the commission shall submit a report, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to government administration. Such report shall include the best practices recommended by the commission under this section and a recommendation on any legislation to implement such practices within state agencies.

(P.A. 21-35, S. 4; P.A. 23-204, S. 190.)

History: P.A. 21-35 effective June 14, 2021; P.A. 23-204 amended Subsec. (a) by replacing “determine” with “recommend” and Subsec. (b) by replacing “2023” with “2024” and “established” with “recommended”, effective June 12, 2023.

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Sec. 19a-133e. Declaration of homelessness as a public health crisis. It is hereby declared that homelessness constitutes a public health crisis in this state and will continue to constitute a public health crisis until the right of homeless persons to receive emergency medical care, as guaranteed pursuant to subdivision (3) of subsection (b) of section 1-500, is adequately safeguarded and protected.

(P.A. 23-195, S. 16.)

History: P.A. 23-195 effective June 29, 2023.

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