Substitute House Bill No. 5836

Public Act No. 00-27

An Act Implementing The Legislative Commissioners' Recommendations For Technical Revisions To Title 19a Of The General Statutes And Certain Other Public Health Statutes.

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

Section 1. Section 17a-248 of the general statutes is repealed and the following is substituted in lieu thereof:

As used in this section and sections 17a-248b to 17a-248g, inclusive, as amended by this act, 38a-490a and [38a-516c] 38a-516a, unless the context otherwise requires:

(1) "Commissioner" means the Commissioner of Mental Retardation.

(2) "Council" means the State Interagency Birth-to-Three Coordinating Council established pursuant to section 17a-248b, as amended by this act.

(3) "Early intervention services" means early intervention services, as defined in 34 CFR Part 303.12, as [amended] from time to time amended.

(4) "Eligible children" means children from birth to thirty-six months of age, who are not eligible for special education and related services pursuant to sections 10-76a to 10-76h, inclusive, as amended, and who need early intervention services because such children are:

(A) Experiencing a significant developmental delay as measured by standardized diagnostic instruments and procedures, including informed clinical opinion, in one or more of the following areas: (i) Cognitive development; (ii) physical development, including vision or hearing; (iii) communication development; (iv) social or emotional development; or (v) adaptive skills; or

(B) Diagnosed as having a physical or mental condition that has a high probability of resulting in developmental delay.

(5) "Evaluation" means a multidisciplinary professional, objective assessment conducted by appropriately qualified personnel in order to determine a child's eligibility for early intervention services.

(6) "Individualized family service plan" means a written plan for providing early intervention services to an eligible child and the child's family.

(7) "Lead agency" means the Department of Mental Retardation, the public agency responsible for the administration of the birth-to-three system in collaboration with the participating [state] agencies.

(8) "Parent" means the child's parent or a person in a parental relationship to the child. With respect to a child who has no parent or person in a parental relationship, "parent" means the person designated to serve in a parental relationship for the purposes of this section and sections 17a-248b to 17a-248g, inclusive, as amended by this act, 38a-490a and [38a-516c] 38a-516a, pursuant to regulations of the Department of Mental Retardation, adopted in accordance with chapter 54 in consultation with the Department of Children and Families, for children in foster care.

(9) "Participating agencies" includes, but is not limited to, the Departments of Education, Social Services, Public Health, Children and Families and Mental Retardation, the Insurance Department, the Board of Education and Services for the Blind, the Commission on the Deaf and Hearing Impaired and the Office of Protection and Advocacy for Persons with Disabilities.

(10) "Qualified personnel" means persons who meet the standards specified in 34 CFR Part 303.12(e), as [amended] from time to time amended, and who are licensed physicians or psychologists or persons holding a state-approved or recognized license, certificate or registration in one or more of the following fields: (A) Special education, including teaching of the blind and the deaf; (B) speech and language pathology and audiology; (C) occupational therapy; (D) physical therapy; (E) social work; (F) nursing; (G) dietary or nutritional counseling; and (H) other fields designated by the commissioner that meet requirements that apply to the area in which the person is providing early intervention services, provided there is no conflict with existing professional licensing, certification and registration requirements.

(11) "Region" means a region within the Department of Mental Retardation.

(12) "Service coordinator" means a person carrying out service coordination, as defined in 34 CFR Part 303.22, as [amended] from time to time amended.

Sec. 2. Section 17a-248b of the general statutes, as amended by section 28 of public act 99-2 of the June special session, is repealed and the following is substituted in lieu thereof:

(a) The lead agency shall establish a State Interagency Birth-to-Three Coordinating Council and shall provide staff assistance and other resources to [such] the council. The council shall consist of the following members, appointed by the Governor: (1) Six parents, including minority parents, of children with disabilities twelve years of age or younger, with knowledge of, or experience with, programs for children from birth to thirty-six months of age with disabilities, at least one of whom shall be a parent of a child six years of age or younger, with a disability; (2) two members of the General Assembly at the time of their appointment, one of whom shall be designated by the speaker of the House of Representatives and one of whom shall be designated by the president pro tempore of the Senate; (3) one person involved in the training of personnel who provide early intervention services; (4) one person who is a member of the American Academy of Pediatrics; (5) one person from each of the participating [state] agencies, who shall be designated by the commissioner or executive director of the participating agency and who have authority to engage in policy planning and implementation on behalf of the participating agency; (6) five approved providers of early intervention services; and (7) a representative of a Head Start program or agency. The Governor shall designate the chairperson of the council who shall not be the designee of the lead agency.

(b) The Governor shall appoint all members of the council for terms of three years.

(c) The council shall meet at least quarterly and shall provide public notice of its meetings, which shall be open and accessible to the general public. Special meetings may be called by the chairperson and shall be called at the request of the [Commissioner of Mental Retardation] commissioner.

(d) Council members who are parents of children with disabilities shall be reimbursed for reasonable and necessary expenses incurred in the performance of their duties [hereunder] under this section.

(e) The council shall: (1) Assist the lead agency in the effective performance of the lead agency's responsibilities under section 17a-248, as amended by this act, this section and sections 17a-248c to 17a-248g, inclusive, as amended by this act, 38a-490a and [38a-516c] 38a-516a, including identifying the sources of fiscal support for early intervention services and programs, assignment of financial responsibility to the appropriate agency, promotion of interagency agreements and preparing applications and amendments required pursuant to federal law; (2) advise and assist the commissioner and other participating agencies in the development of standards and procedures pursuant to said sections; (3) advise and assist the commissioner and the Commissioner of Education regarding the transition of children with disabilities to services provided under sections 10-76a to 10-76h, inclusive, as amended; (4) advise and assist the commissioner in identifying barriers that impede timely and effective service delivery, including advice and assistance with regard to interagency disputes; and (5) prepare and submit an annual report in accordance with section 11-4a to the Governor and the General Assembly on the status of the birth-to-three system. At least thirty days prior to the commissioner's final approval of rules and regulations pursuant to section 17a-248, as amended by this act, this section, sections 17a-248c to 17a-248g, inclusive, as amended by this act, 38a-490a and [38a-516c] 38a-516a, other than emergency rules and regulations, the commissioner shall submit proposed rules and regulations to the council for its review. The council shall review all proposed rules and regulations and report its recommendations thereon to the commissioner within thirty days. The commissioner shall not act in a manner inconsistent with the recommendations of the council without first providing the reasons for such action. The council, upon a majority vote of its members, may require that an alternative approach to the proposed rules and regulations be published with a notice of the proposed rules and regulations pursuant to chapter 54. When an alternative approach is published pursuant to this section, the commissioner shall state the reasons for not selecting such alternative approach.

Sec. 3. Subsection (a) of section 17a-248c of the general statutes is repealed and the following is substituted in lieu thereof:

(a) The commissioner shall establish at least one local interagency coordinating council in each region of the state. The council shall consist of at least four members who are parents of children aged birth to three with disabilities or of children aged three through twelve with disabilities. Each such council shall also include a representative from the medical community, at least three public or private providers of early intervention services, at least one child care provider or representative of child care providers, regional representatives of participating agencies, if appropriate, and a representative of at least one local public school district. The commissioner may waive one or more of the [foregoing] membership composition requirements set forth in this subsection in those regions where such requirements cannot reasonably be met.

Sec. 4. Section 17a-248d of the general statutes is repealed and the following is substituted in lieu thereof:

(a) [Effective July 1, 1996, the] The lead agency, in coordination with the participating agencies and in consultation with the council, shall establish and maintain a state-wide birth-to-three system of early intervention services pursuant to Part H of the Individuals with Disabilities Education Act, 20 USC 1471 et seq., for eligible children and families of such children.

(b) The state-wide system shall include a system for compiling data on the number of eligible children in the state in need of appropriate early intervention services, the number of such eligible children and their families served, the types of services provided and other information as deemed necessary by the lead agency.

(c) The state-wide system shall include a comprehensive child-find system and public awareness program to ensure that eligible children are identified, located, referred to the system and evaluated. The following persons and entities, within two working days of identifying a child from birth to three years of age suspected of having a developmental delay or of being at risk of having a developmental delay, shall refer the parent of such child to the early intervention system unless the person knows the child has already been referred: (1) Hospitals; (2) child health care providers; (3) local school districts; (4) public health facilities; (5) early intervention service providers; (6) participating agencies; and (7) such other social service and health care agencies and providers as the commissioner specifies in regulation.

(d) The commissioner, in coordination with the participating [state] agencies and in consultation with the council, shall adopt regulations, pursuant to chapter 54, to carry out the provisions of section 17a-248, as amended by this act, and sections 17a-248b to 17a-248g, inclusive, as amended by this act, 38a-490a and [38a-516c] 38a-516a.

Sec. 5. Section 17a-248g of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Subject to the provisions of this section, funds appropriated to the lead agency for purposes of section 17a-248, as amended by this act, sections 17a-248b to 17a-248f, inclusive, as amended by this act, this section and sections 38a-490a and [38a-516c] 38a-516a shall not be used to satisfy a financial commitment for services that would have been paid from another public or private source but for the enactment of said sections, except for federal funds available pursuant to Part H of the Individuals with Disabilities Education Act, 20 USC 1471 et seq., except that whenever considered necessary to prevent the delay in the receipt of appropriate early intervention services by the eligible child or family in a timely fashion, funds provided under said sections may be used to pay the service provider pending reimbursement from the public or private source that has ultimate responsibility for the payment.

(b) Nothing in section 17a-248, as amended by this act, sections 17a-248b to 17a-248f, inclusive, as amended by this act, this section and sections 38a-490a and [38a-516c] 38a-516a shall be construed to permit the Department of Social Services or any other state agency to reduce medical assistance pursuant to this chapter or other assistance or services available to eligible children. Notwithstanding any [other provisions] provision of the general statutes, costs incurred for early intervention services that otherwise qualify as medical assistance that are furnished to an eligible child who is also eligible for benefits pursuant to this chapter shall be considered medical assistance for purposes of payments to providers and state reimbursement to the extent that federal financial participation is available for such services.

(c) Providers of early intervention services shall, in the first instance and where applicable, seek payment from all third-party payers prior to claiming payment from the birth-to-three system for services rendered to eligible children, provided, for the purpose of seeking payment from the Medicaid program or from other third-party payers as agreed upon by the provider, the obligation to seek payment shall not apply to a payment from a third-party payer who is not prohibited from applying such payment, and who will apply such payment, to an annual or lifetime limit specified in the third-party payer's policy or contract.

(d) The [Commissioner of Mental Retardation] commissioner, in consultation with the Office of Policy and Management and the Insurance Commissioner, shall adopt regulations, pursuant to chapter 54, providing public reimbursement for deductibles and copayments imposed under an insurance policy or health benefit plan to the extent that such deductibles and copayments are applicable to early intervention services.

(e) The [Commissioner of Mental Retardation] commissioner shall establish a schedule of fees based on a sliding scale for early intervention services. The schedule of fees shall consider the cost of such services relative to the financial resources of the parents or legal guardians of eligible children. The Department of Mental Retardation may assign its right to collect fees to a designee or provider participating in the early intervention program and providing services to a recipient in order to assist the provider in obtaining payment for such services. The commissioner may implement procedures for the collection of the schedule of fees while in the process of adopting such criteria in regulation provided the commissioner prints notice of intention to adopt the regulations in the Connecticut Law Journal within twenty days of implementing the policy. Such collection procedures and schedule of fees shall be valid until the time the final regulations are effective.

(f) The [Commissioner of Mental Retardation] commissioner shall develop and implement procedures to hold a recipient harmless for the impact of pursuit of payment for early intervention services against lifetime insurance limits.

(g) Notwithstanding any provision of title 38a relating to the permissible exclusion of payments for services under governmental programs, no such exclusion shall apply with respect to payments made pursuant to section 17a-248, as amended by this act, sections 17a-248b to 17a-248f, inclusive, as amended by this act, this section and sections 38a-490a and [38a-516c] 38a-516a. Except as provided in this subsection, nothing in this section shall increase or enhance coverages provided for within an insurance contract subject to the provisions of section 10-94f, subsection (a) of section 10-94g, subsection (a) of section 17a-219b, subsection (a) of section 17a-219c, sections 17a-248, as amended by this act, 17a-248b to 17a-248f, inclusive, as amended by this act, this section, and sections 19a-1c, as amended, 38a-490a and [38a-516c] 38a-516a.

Sec. 6. Subsection (b) of section 17a-667 of the general statutes, as amended by section 35 of public act 99-2 of the June special session, is repealed and the following is substituted in lieu thereof:

(b) The council shall consist of the following members: (1) The Secretary of the Office of Policy and Management, or [his] the secretary's designee; (2) the Commissioners of Children and Families, Consumer Protection, Correction, Education, Higher Education, Mental Health and Addiction Services, Motor Vehicles, Public Health, Public Safety, Social Services [,] and Transportation and the Insurance Commissioner, or their designees; (3) the Chief Court Administrator, or [his] the Chief Court Administrator's designee; (4) the [chairman] chairperson of the Board of Parole, or [his] the chairperson's designee; (5) the Chief State's Attorney, or [his] the Chief State's Attorney's designee; (6) the Chief Public Defender, or [his] the Chief Public Defender's designee; and (7) the cochairpersons and ranking members of the joint standing committees of the General Assembly having cognizance of matters relating to public health, criminal justice and appropriations, or their designees. The Commissioner of Mental Health and Addiction Services shall be [chairman] chairperson of the council. The Office of Policy and Management shall, within available appropriations, provide staff for the council. [The chairman of the council shall schedule the first meeting of the council to be held not later than October 1, 1997.]

Sec. 7. Section 17a-688 of the general statutes, as amended by section 5 of public act 99-234, is repealed and the following is substituted in lieu thereof:

(a) All records maintained by the court of cases coming before it under the provisions of sections 17a-465a, 17a-673, as amended, and 17a-680 to 17a-690, inclusive, as amended, shall be sealed and available only to the respondent or [his] the respondent's counsel unless the court, after hearing held with notice to the respondent, determines such record should be disclosed for cause shown.

(b) Medical treatment facilities shall keep and submit such records of all persons examined, admitted or treated pursuant to sections 17a-465a, 17a-673, as amended, and 17a-680 to 17a-690, inclusive, as amended, as may be required by the department.

(c) No person, hospital [,] or treatment facility [or the department] may disclose or permit the disclosure of, nor may the department disclose or permit the disclosure of, the identity, diagnosis, prognosis or treatment of any such patient that would constitute a violation of federal statutes concerning confidentiality of alcohol or drug patient records and any regulations pursuant thereto, [or as they] as such federal statutes and regulations may be amended from time to time. The department shall adopt regulations, in accordance with chapter 54, to protect the confidentiality of any such information that is obtained by [it] the department.

(d) If the person seeking treatment or rehabilitation for alcohol dependence or drug dependence is a minor, the fact that the minor sought such treatment or rehabilitation or that [he] the minor is receiving such treatment or rehabilitation, shall not be reported or disclosed to the parents or legal guardian of the minor without [his] the minor's consent. The minor may give legal consent to receipt of such treatment and rehabilitation. A minor shall be personally liable for all costs and expenses for alcohol and drug dependency treatment afforded [him at his] to the minor at the minor's request under section 17a-682.

(e) The commissioner may use or make available to authorized persons information from patients' records for purposes of conducting scientific research, management audits, financial audits [,] or program evaluation, provided such information shall not be utilized in a manner that discloses a patient's name or other identifying information.

Sec. 8. Subsection (b) of section 19a-17n of the general statutes is repealed and the following is substituted in lieu thereof:

(b) The participating physician shall not accept compensation for providing health care services from patients served pursuant to this section and section 19a-17m, nor from clinics serving these patients. As used in this [act] section and section 19a-17m, "compensation" means any remuneration of value to the participating physician for services provided by the physician, but shall not be construed to include any nominal copayments charged by the clinic, nor reimbursement of related expenses of a participating physician authorized by the clinic in advance of being incurred.

Sec. 9. Section 19a-58 of the general statutes is repealed and the following is substituted in lieu thereof:

The Department of Public Health shall develop a pamphlet which: (1) Specifies the indicators for high risk of hearing impairment in infants; (2) explains the diagnostic procedures which should be carried out to determine whether a hearing impairment actually exists or may potentially develop and where such diagnostic services are available; (3) alerts parents to the resources available for the treatment and education of infants and children that develop hearing impairments; [,] and (4) contains any other information the department deems necessary. The Department of Public Health shall make the pamphlet available to hospitals and physicians for distribution to the parents or guardians of infants that have been identified as having high risk for hearing impairment. The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to develop indicators of high risk of infant hearing impairment. In developing such indicators, the commissioner shall consult with persons, including but not limited to, pediatricians, otolaryngologists and audiologists.

Sec. 10. Subsection (b) of section 19a-59 of the general statutes, as amended by section 36 of public act 99-2 of the June special session, is repealed and the following is substituted in lieu thereof:

(b) The Department of Public Health shall establish a plan to implement and operate a program of early identification of infant hearing impairment. The purpose of such plan shall be to: (1) Identify infants at high risk of having hearing impairments; (2) notify parents of such infants of the risk; (3) inform parents of resources available to them for further testing and treatment, including rehabilitation services for such infants; [,] and (4) inform parents of financial assistance available through the Department of Public Health, including, but not limited to, parental eligibility criteria, which may result in reduced cost or no cost to parents for testing, evaluation or treatment, including rehabilitation of such infants. The department shall develop such plan in consultation with persons including, but not limited to, pediatricians, otolaryngologists, audiologists, educators and parents of deaf and hearing impaired children.

Sec. 11. Subsection (a) of section 19a-87b of the general statutes is repealed and the following is substituted in lieu thereof:

(a) No person, group of persons, association, organization, corporation, institution or agency, public or private, shall maintain a family day care home, as defined in section 19a-77, without a license issued by the Commissioner of Public Health. Licensure forms shall be obtained from the Department of Public Health. Applications for licensure shall be made to the [Commissioner of Public Health] commissioner on forms provided by the department 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 of Public Health] commissioner pursuant to subsection [(b)] (c) of this section. Before a family day care home license is granted, the department 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 department shall include an inspection for evident sources of lead poisoning. The department shall provide for a chemical analysis of any paint chips found on such premises. The commissioner shall not require an annual inspection for homes seeking license renewal or for licensed homes, except that the commissioner shall make unannounced visits, during customary business hours, to at least thirty-three and one-third per cent of the licensed family day care homes each year. A licensed family day care home shall not be subject to any conditions on the operation of such home by local officials, other than those imposed by the department pursuant to this subsection, if the home complies with all local codes and ordinances applicable to single and multifamily dwellings.

Sec. 12. Subsection (d) of section 19a-87b of the general statutes is repealed and the following is substituted in lieu thereof:

(d) Applications for initial licensure under this section shall be accompanied by a fee of [ten dollars and such licenses shall be issued for a term of one year, except that, on and after December 31, 1995, such applications shall be accompanied by a fee of] twenty dollars and such licenses shall be issued for a term of two years. Applications for renewal of licenses granted under this section shall be accompanied by a fee of [ten dollars and such licenses shall be renewed for a term of one year, except that, for licenses expiring on and after December 31, 1995, applications for renewal shall be accompanied by a fee of] twenty dollars and such licenses shall be renewed for a term of two years. No such license shall be renewed unless the licensee certifies that the children enrolled in the family day care home have received age-appropriate immunization in accordance with regulations adopted pursuant to subsection [(b)] (c) of this section.

Sec. 13. Subsection (c) of section 19a-87e of the general statutes is repealed and the following is substituted in lieu thereof:

(c) Any person who is licensed to conduct, operate or maintain a family day care home shall notify the commissioner of any conviction of the owner, conductor, operator or maintainer of the family day care home or of any person residing in the household or any person employed [therein] in such family day care home in a position connected with the provision of care to a child receiving child day care services, of a crime which affects the commissioner's discretion under subsection (a) of this section, immediately upon obtaining knowledge of such conviction. Failure to comply with the notification requirement of this subsection may result in the suspension or revocation of the license or [take] the taking of any other action against a license set forth in regulation adopted pursuant to section 19a-79 and shall subject the licensee to a civil penalty of not more than one hundred dollars per day for each day after the person obtained knowledge of the conviction.

Sec. 14. Section 19a-88 of the general statutes, as amended by section 17 of public act 99-102, section 4 of public act 99-249 and section 61 of public act 99-2 of the June special session, is repealed and the following is substituted in lieu thereof:

(a) Each person holding a license to practice dentistry, optometry, midwifery or dental hygiene shall, annually, during the month of [his] such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class I, as defined in section 33-182l in the case of a dentist, the professional services fee for class H, as defined in section 33-182l in the case of an optometrist, [except that in the fiscal year ending June 30, 1993, optometrists shall pay a fee of three hundred seventy-five dollars,] five dollars in the case of a midwife, and fifty dollars in the case of a dental hygienist, on blanks to be furnished by the department for such purpose, giving [his] such person's name in full, [his] such person's residence and business address and such other information as the department requests.

(b) Each person holding a license to practice medicine, surgery, podiatry, chiropractic or natureopathy shall, annually, during the month of [the] such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class I, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving [his] such person's name in full, [his] such person's residence and business address and such other information as the department requests.

(c) (1) Each person holding a license to practice as a registered nurse, shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class B, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, [with] such person's residence and business address and such other information as the department requests. Each person holding a license to practice as a registered nurse who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class B, as defined in section 33-182l. Any license provided by the department at a reduced fee shall indicate that the registered nurse is retired.

(2) Each person holding a license as an advanced practice registered nurse shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class C, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, [with] such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the person maintains current certification as either a nurse practitioner, a clinical nurse specialist or a nurse anesthetist from one of the following national certifying bodies which certify nurses in advanced practice: The American Nurses' Association, the Nurses' Association of the American College of Obstetricians and Gynecologists Certification Corporation, the National Board of Pediatric Nurse Practitioners and Associates or the American Association of Nurse Anesthetists. Each person holding a license to practice as an advanced practice registered nurse who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class C, as defined in section 33-182l. Any license provided by the department at a reduced fee shall indicate that the advanced practice registered nurse is retired.

(3) Each person holding a license as a licensed practical nurse shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class A, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, [with] such person's residence and business address and such other information as the department requests. Each person holding a license to practice as a licensed practical nurse who has retired from the profession may renew such license, but the fee shall be ten per cent of the professional services fee for class A, as defined in section 33-182l. Any license provided by the department at a reduced fee shall indicate that the licensed practical nurse is retired.

(4) Each person holding a license as a nurse-midwife shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class C, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, [with] such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the person maintains current certification from the American College of Nurse-Midwives.

(5) Each person holding a license to practice physical therapy shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of the professional services fee for class B, as defined in section 33-182l, on blanks to be furnished by the department for such purpose, giving such person's name in full, [with] such person's residence and business address and such other information as the department requests.

(6) Each person holding a license as a physician assistant shall, annually, during the month of such person's birth, register with the Department of Public Health, upon payment of a fee of seventy-five dollars, on blanks to be furnished by the department for such purpose, giving such person's name in full, [with] such person's residence and business address and such other information as the department requests. No such license shall be renewed unless the department is satisfied that the practitioner has met the mandatory continuing medical education requirements of the National Commission on Certification of Physician Assistants or a successor organization for the certification or recertification of physician assistants that may be approved by the department and has passed any examination or continued competency assessment the passage of which may be required by said commission for maintenance of current certification by said commission.

(d) No provision of this section shall be construed to apply to any person practicing Christian Science.

(e) Each person holding a license or certificate issued under section 19a-514, 20-74s, as amended, 20-195cc or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to 381a, inclusive, 383 to 388, inclusive, 393a, 395, 398, 399 or 400a and section 20-206n, 20-206o or section 56 of [this act] public act 99-2 of the June special session shall, annually, during the month of [the applicant's] such person's birth, apply for renewal of such license or certificate to the Department of Public Health, giving [the applicant's] such person's name in full, [the applicant's] such person's residence and business address and such other information as the department requests. Each person holding a license or certificate issued pursuant to section 20-475 or 20-476 shall, annually, during the month of [the applicant's] such person's birth, apply for renewal of such license or certificate to the department. Each entity holding a license issued pursuant to section 20-475 shall, annually, during the anniversary month of initial licensure, apply for renewal of such license or certificate to the department.

(f) Any person or entity which fails to comply with the provisions of this section shall be notified by the department that [his] such person's or entity's license or certificate shall become void ninety days after the time for its renewal under this section unless it is so renewed. Any such license shall become void upon the expiration of such ninety-day period.

Sec. 15. Section 19a-91 of the general statutes is repealed and the following is substituted in lieu thereof:

The Department of Public Health may [make] adopt such regulations, in accordance with chapter 54, concerning the preparation and transportation of the bodies of deceased persons to be removed from or into the limits of any town or into any adjoining state, as the public health and welfare may require. Such regulations shall be signed by the Commissioner of Public Health, and a copy thereof shall be mailed to each town clerk, licensed embalmer and funeral director at least fifteen days before [the same] such regulations take effect. Any person who violates any regulation of [said] the department [made] adopted pursuant to the provisions of this section shall be fined not more than fifty dollars.

Sec. 16. Section 19a-113 of the general statutes is repealed and the following is substituted in lieu thereof:

The Commissioner of Public Health shall [establish] adopt, in accordance with chapter 54, and enforce regulations concerning the quality of the compressed air sold for use in self-contained underwater breathing apparatus. No compressed air shall be sold or distributed for such use unless it complies with the standards of quality established by [said] the commissioner. Any person who violates the provisions of this section shall be fined not more than five hundred dollars or imprisoned not more than five months, or both.

Sec. 17. Section 19a-183 of the general statutes is repealed and the following is substituted in lieu thereof:

There shall be established an emergency medical services council in each region. A region shall be composed of the towns so designated by the commissioner. Opportunity for membership shall be available to all appropriate representatives of emergency medical services including, but not limited to, one representative from each of the following: [(a)] (1) Local governments; [, (b)] (2) fire and law enforcement officials; [, (c)] (3) medical and nursing professions, including mental health, paraprofessional and other allied health professionals; [, (d)] (4) providers of ambulance services, at least one of which shall be a member of a volunteer ambulance association; [, (e)] (5) institutions of higher education; [, (f)] (6) federal agencies involved in the delivery of health care; [, and (g)] and (7) consumers. All emergency medical services councils, including those in existence on July 1, 1974, shall submit to the [Commissioner of Public Health] commissioner information concerning the organizational structure and council bylaws for [his] the commissioner's approval. The commissioner shall foster the development of emergency medical services councils in each region.

Sec. 18. Subsection (a) of section 19a-215 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) For the purposes of this section:

(1) "Commissioner's list of reportable diseases and laboratory findings" means the list developed pursuant to section [19a-5] 19a-2a.

(2) "Confidential" means confidentiality of information pursuant to section 19a-25.

(3) "Health care provider" means a person who has direct or supervisory responsibility for the delivery of health care or medical services, [. This shall include] including licensed physicians, nurse practitioners, nurse midwives, physician assistants, nurses, dentists, medical examiners and administrators, superintendents and managers of health care facilities.

Sec. 19. Section 19a-240 of the general statutes is repealed and the following is substituted in lieu thereof:

[The word "board", as] As used in this chapter, unless the context otherwise requires, "board" means a board of a district department of health created as provided [herein, unless the context otherwise indicates] in section 19a-241, as amended.

Sec. 20. Subsection (a) of section 19a-243 of the general statutes, as amended by section 11 of public act 99-234, is repealed and the following is substituted in lieu thereof:

(a) Each [such] board may make and adopt reasonable rules and regulations for the promotion of general health within the district not in conflict with law or with the Public Health Code. The powers of each district shall include but not be limited to the following enumerated powers: (1) To sue and be sued; (2) to make and execute contracts and other instruments necessary or convenient to the exercise of the powers of the health district; (3) to make and from time to time amend and repeal bylaws, rules and regulations; (4) to acquire real estate; (5) to provide for the financing of the programs, projects or other functions of the district in the manner described in subsection (b) of this section; and (6) to have [whatever] such other powers as are necessary to properly carry out [their] its powers as an independent entity of government.

Sec. 21. Section 19a-330 of the general statutes is repealed and the following is substituted in lieu thereof:

Any person who uses or produces any carcinogenic substance in the manufacture of any item, product or material shall make an annual report to the Commissioner of Environmental Protection and the Commissioner of Public Health. [which] Such report shall include: [(A)] (1) The method of disposal of any waste generated by the manufacture of such item, product or material; [, (B)] (2) the amount of each such carcinogenic substance used or produced during the preceding year; [, (C)] (3) the amount of each such carcinogenic substance currently being held in inventory; [, and (D)] and (4) the method used to transport such carcinogenic substances.

Sec. 22. Section 19a-331 of the general statutes is repealed and the following is substituted in lieu thereof:

The Commissioner of Public Health shall, by means of regulations adopted in accordance with [the provisions of] chapter 54, identify substances, including gases, chemicals or metals, which are designated human carcinogens. [and said] The commissioner may [promulgate] adopt regulations, in accordance with chapter 54, to implement the provisions of this chapter.

Sec. 23. Subdivision (1) of section 19a-630 of the general statutes, as amended by section 2 of public act 99-172, is repealed and the following is substituted in lieu thereof:

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

Sec. 24. This act shall take effect from its passage.

Approved May 1, 2000