Substitute House Bill No. 6994

Public Act No. 99-102

An Act Merging the Boards and Licensure Requirements of Osteopathic and Allopathic Medicine.

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

Section 1. Section 20-1 of the general statutes is repealed and the following is substituted in lieu thereof:

The practice of the healing arts means the practice of medicine, [osteopathy,] chiropractic, podiatry, natureopathy [,] and, except as used in chapters 384a and 388, and sections 19a-16a to 19a-16c, inclusive, the practice of optometry.

Sec. 2. Section 20-9 of the general statutes is amended by adding subsection (e) as follows:

(NEW) (e) On and after October 1, 1999, any person licensed as an osteopathic physician or osteopath pursuant to chapter 371 shall be deemed licensed as a physician and surgeon pursuant to this chapter.

Sec. 3. Section 20-10 of the general statutes is repealed and the following is substituted in lieu thereof:

Except as provided in section 20-12, [no person shall receive a license under the provisions of section 20-13 until he files a statement with the Department of Public Health certifying that he] each person applying for a license under section 20-13 shall certify to the Department of Public Health that the applicant: (1) (A) Is a graduate of a medical school located in the United States or Canada [which is] accredited by the Liaison Committee on Medical Education or of a medical education program accredited by the American Osteopathic Association, or (B) is a graduate of a medical school located outside the United States or Canada and has received the degree of doctor of medicine, osteopathic medicine or its equivalent and satisfies educational requirements specified in regulations adopted pursuant to this chapter and has either (i) successfully completed all components of a "fifth pathway program" conducted by an American medical school accredited by the American Medical Association or the American Osteopathic Association, or (ii) received certification from the Educational Commission for Foreign Medical Graduates; (2) has successfully completed not less than two years of progressive graduate medical training as a resident physician in a program accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association or an equivalent program approved by the board with the consent of the department; and (3) has passed an examination prescribed by the [Department of Public Health] department with the advice and consent of the appropriate examining board. Examinations required under this section shall be administered by the Department of Public Health under the supervision of the appropriate examining board. Passing scores shall be established by said department with the consent of the appropriate examining board. The department may, under such regulations as the Commissioner of Public Health may adopt, with the advice and assistance of the appropriate board, deny eligibility for licensure to a graduate who has been found to have provided fraudulent or inaccurate documentation regarding either [his] the graduate's school's educational program or [his] academic credentials or to have failed to meet educational standards as prescribed in such regulations.

Sec. 4. Section 20-8a of the general statutes is repealed and the following is substituted in lieu thereof:

(a) There shall be within the Department of Public Health a Connecticut Medical Examining Board. Said board shall consist of [twelve] fifteen members appointed by the Governor, subject to the provisions of section 4-9a, in the manner prescribed for department heads in section 4-7, as follows: [Four] Five physicians practicing in the state; one physician who shall be a full-time member of the faculty of The University of Connecticut School of Medicine; one physician who shall be a full-time chief of staff in a general-care hospital in the state; one physician who shall be registered as a supervising physician for one or more physician assistants; one physician who shall be a graduate of a medical education program accredited by the American Osteopathic Association; one physician assistant licensed pursuant to section 20-12b and practicing in this state; and [four] five public members. No professional member of said board shall be an elected or appointed officer of a professional society or association relating to [his] such member's profession at the time of [his] appointment to the board or have been such an officer during the year immediately preceding [such] appointment or serve for more than two consecutive terms. Professional members shall be practitioners in good professional standing and residents of this state.

(b) All vacancies shall be filled by the Governor in the manner prescribed for department heads in section 4-7. Successors and appointments to fill a vacancy shall fulfill the same qualifications as the member succeeded or replaced. In addition to the requirements in sections 4-9a and 19a-8, no person whose spouse, parent, brother, sister, child or spouse of a child is a physician, as defined in [subdivision (5) of] section 20-13a, as amended by this act, or a physician assistant, as defined in [subdivision (5) of] section 20-12a, as amended by this act, shall be appointed as a public member.

(c) The Commissioner of Public Health shall establish a list of sixteen persons who may serve as members of medical hearing panels established pursuant to subsection (g) of this section. Persons appointed to the list shall serve as members of the medical hearing panels and provide the same services as members of the Connecticut Medical Examining Board. Members from the list serving on such panels shall not be voting members of the Connecticut Medical Examining Board. The list shall consist of sixteen members appointed by the commissioner, eight of whom shall be physicians, [licensed pursuant to section 20-10] as defined in section 20-13a, as amended by this act, with at least one of such physicians being a graduate of a medical education program accredited by the American Osteopathic Association and eight of whom shall be members of the public. No professional member of the list shall be an elected or appointed officer of a professional society or association relating to [his] such member's profession at the time of [his] appointment to the list or have been such an officer during the year immediately preceding such appointment to the list. A licensed professional appointed to the list shall be a practitioner in good professional standing and a resident of this state. All vacancies shall be filled by the commissioner. Successors and appointments to fill a vacancy [of] on the list shall possess the same qualifications as those required of the member succeeded or replaced. No person whose spouse, parent, brother, sister, child or spouse of a child is a physician, as defined in [subdivision (5) of] section 20-13a, as amended by this act, or a physician assistant, as defined in [subdivision (5) of] section 20-12a, as amended by this act, shall be appointed to the list as a member of the public. Each person appointed to the list shall serve without compensation at the pleasure of the commissioner.

(d) The office of the board shall be in Hartford, in facilities to be provided by the department.

(e) The board shall adopt and may amend a seal.

(f) The Governor shall appoint a chairperson from among the board members. Said board shall meet at least once during each calendar quarter and at such other times as the chairperson deems necessary. Special meetings shall be held on the request of a majority of the board after notice in accordance with the provisions of section 1-225. A majority of the members of the board shall constitute a quorum. Members shall not be compensated for their services. Any member who fails to attend three consecutive meetings or who fails to attend fifty per cent of all meetings held during any calendar year shall be deemed to have resigned from office. Minutes of all meetings shall be recorded by the board. No member shall participate in the affairs of the board during the pendency of any disciplinary proceedings by the board against such member. Said board shall (1) hear and decide matters concerning suspension or revocation of licensure, (2) adjudicate complaints against practitioners, and (3) impose sanctions where appropriate.

(g) The board shall refer all statements of charges filed with the board by the department pursuant to section 20-13e to a medical hearing panel within sixty days of the receipt of charges. This time period may be extended for good cause by the board in a duly recorded vote. The panel shall consist of three members, at least one of whom shall be a member of the board and one a member of the public. The public member may be a member of either the board or of the list established pursuant to subsection (c) of this section. The panel shall conduct a hearing in accordance with the provisions of chapter 54 and the regulations established by the Commissioner of Public Health concerning contested cases, except that the panel shall file a proposed final decision with the board within one hundred twenty days of the receipt of the issuance of the notice of hearing by the board. The time period for filing such proposed final decision with the board may be extended for good cause by the board in a duly recorded vote.

(h) The board shall review the panel's proposed final decision in accordance with the provisions of section 4-179, and adopt, modify or remand said decision for further review or for the taking of additional evidence. The board shall act on the proposed final decision within ninety days of the filing of said decision by the panel. This time period may be extended by the board for good cause in a duly recorded vote.

(i) Except in a case in which a license has been summarily suspended, pursuant to subsection (c) of section 19a-17 or subsection (c) of section 4-182, all three panel members shall be present to hear any evidence and vote on a proposed final decision. The chairperson of the Medical Examining Board may exempt a member from a meeting of the panel if the chairperson finds that good cause exists for such an exemption. Such an exemption may be granted orally but shall be reduced to writing and included as part of the record of the panel within two business days of the granting of the exemption or the opening of the record and shall state the reason for the exemption. Such exemption shall be granted to a member no more than once during any contested case and shall not be granted for a meeting at which the panel is acting on a proposed final decision on a statement of charges. The board may appoint a member to the panel to replace any member who resigns or otherwise fails to continue to serve on the panel. Such replacement member shall review the record prior to the next hearing.

(j) A determination of good cause shall not be reviewable and shall not constitute a basis for appeal of the decision of the board pursuant to section 4-183.

Sec. 5. Section 20-11a of the general statutes is repealed and the following is substituted in lieu thereof:

(a) No person shall participate in an intern or resident physician program or United States medical officer candidate training program until [he] such person has received a permit issued by the Department of Public Health. The permit shall be issued solely for purposes of participation in graduate education as an intern, resident or medical officer candidate in a hospital. No person shall receive a permit until a statement has been filed with the department on [his] the applicant's behalf by the hospital administrator certifying that [he] the applicant is to be appointed an intern, resident or medical officer candidate in the hospital and that [he] the applicant has received the degree of doctor of medicine, osteopathic medicine or its equivalent and, if educated outside the United States or Canada (1) has successfully completed all components of a "fifth pathway program" conducted by an American medical school accredited by the Liaison Committee on Medical Education or the American Osteopathic Association, (2) received certification from the Educational Commission for Foreign Medical Graduates, [or] (3) has successfully completed the examination for licensure prescribed by the department pursuant to section 20-10, or (4) holds a current valid license in another state or territory.

(b) No person shall participate in a clinical clerkship program unless [he] such person is (1) a student in a medical school located in the United States or Canada [which is] accredited by the Liaison Committee on Medical Education or the American Osteopathic Association; or (2) is a third or fourth year student in a medical school located outside the United States or Canada, provided the clerkship is conducted in a hospital [which] that has a residency program accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association in the clinical area of the clerkship or in a hospital [which] that is a primary affiliated teaching hospital of a medical school accredited by the Liaison Committee on Medical Education.

Sec. 6. Section 20-12 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Except as hereinafter provided, in lieu of the examination required in section 20-10, the department may, under such regulations as the Commissioner of Public Health, with advice and assistance from the appropriate board, may establish [,] and, upon receipt of four hundred fifty dollars, accept a license from the board of medical examiners or any board authorized to issue a license to practice osteopathic medicine, osteopathy or its equivalent of any state or territory of the United States or the District of Columbia or the Medical Council of Canada or of any agency in such jurisdictions authorized to issue licenses to practice medicine, osteopathic medicine or osteopathy, provided the applicant obtained such license after an examination substantially similar to or of higher quality than that required for a license in this state, has met all the requirements of section 20-10 except for examination and is a currently practicing, competent practitioner of good professional standing. The department may issue to an applicant approved without examination as hereinbefore provided a license to practice medicine and surgery.

(b) Except as hereinafter provided, the department may, in its discretion, and on receipt of four hundred fifty dollars, likewise accept and approve, in lieu of the examination required in section 20-10, a diploma of the National Board of Medical Examiners or a certificate of the National Board of Osteopathic Medical Examiners, subject to the same conditions as hereinbefore set forth for acceptance, in lieu of examination, of a license from a board of medical examiners or any board authorized to issue a license to practice osteopathic medicine, osteopathy or its equivalent of any state or territory of the United States or the District of Columbia or the Medical Council of Canada, and may issue to such diplomate or certificate holder a statement certifying to the fact that the person named therein has been found qualified to practice medicine and surgery.

(c) In lieu of the examination required in section 20-10, the department may, under such regulations as the Commissioner of Public Health, with advice and assistance from the appropriate board, may establish, and upon the receipt of one hundred fifty dollars, accept and approve the application of any physician for a temporary license to practice solely in any state facility, and issue such license, subject to the same conditions set forth in subsection (a) of this section for the acceptance of a license from another jurisdiction or the application of a person who has been a resident student in and a graduate of a medical school listed in the World Health Organization Directory, and has received the degree of doctor of medicine, osteopathic medicine or other academic distinction that, in the judgment of such board, is equivalent to the degree of doctor of medicine or osteopathic medicine from such a school and has completed an additional year of postgraduate experience subsequent to the receipt of said degree. Such temporary license shall not be issued for a period longer than twelve months. During the period such temporary license is in effect, such physician shall make application for an examination administered or approved by the department under the supervision of the appropriate board.

(d) No license shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint. The department shall inform the boards established under sections 20-8 and 20-8a annually of the number of applications it receives for licensure under this section.

(e) Any physician licensed in another state, whose standards for licensure are equivalent to or greater than those required in this state, may practice as a youth camp physician in this state without a license for a period not to exceed nine weeks.

(f) Any physician licensed or otherwise authorized to practice medicine by the armed forces of the United States may practice as a physician without a license in a free clinic in this state provided (1) the physician does not receive payment for such practice, and (2) the physician carries, either directly or through the clinic, professional liability insurance or indemnity against liability for professional malpractice equal to or greater than that required of state-licensed physicians under section 20-11b.

Sec. 7. Section 20-12a of the general statutes is repealed and the following is substituted in lieu thereof:

As used in sections 20-12a to 20-12g, inclusive:

(1) "Accredited physician assistant program" means a physician assistant program accredited, at the time of the applicant's graduation, by the Committee on Allied Health Education and Accreditation of the American Medical Association, the Commission on Accreditation of Allied Health Education Programs or such successor organization for the accreditation of physician assistant programs as may be approved by the department.

(2) "Board" means the Connecticut Medical Examining Board, established pursuant to section 20-8a.

(3) "Department" means the Department of Public Health.

(4) "National commission" means 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.

(5) "Physician assistant" means an individual who: (A) Functions in a dependent relationship with a physician licensed pursuant to this chapter; [or an osteopathic physician licensed pursuant to chapter 371] and (B) is licensed pursuant to section 20-12b to provide patient services under the supervision, control, responsibility and direction of said physician. [or osteopathic physician.]

(6) "Supervising physician" means a physician licensed pursuant to this chapter [or an osteopathic physician licensed pursuant to chapter 371] who is registered with the department pursuant to section 20-12c and who assumes responsibility for the supervision of services rendered by a physician assistant.

(7) "Supervision" means the exercise by the supervising physician of oversight, control and direction of the services of a physician assistant. Supervision includes but is not limited to: (A) Continuous availability of direct communication either in person or by radio, telephone or telecommunications between the physician assistant and the supervising physician; (B) active and continuing overview of the physician assistant's activities to ensure that the supervising physician's directions are being implemented and to support the physician assistant in the performance of his services; (C) personal review by the supervising physician of the physician assistant's practice at least weekly or more frequently as necessary to ensure quality patient care; (D) review of the charts and records of the physician assistant on a regular basis as necessary to ensure quality patient care; (E) delineation of a predetermined plan for emergency situations; and (F) designation of an alternate licensed physician [or osteopathic physician] in the absence of the supervising physician.

Sec. 8. Section 20-12c of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Each physician assistant practicing in this state or participating in a resident physician assistant program shall have a clearly identified supervising physician who maintains the final responsibility for the care of patients and the performance of the physician assistant. No physician assistant issued a license or temporary permit by the department shall practice until such time as a supervising physician has been registered with the department. An individual may register with the department as a supervising physician provided [he] the individual: (1) Possesses a current unrestricted license to practice medicine [or osteopathy] issued pursuant to this chapter; [or chapter 371;] and (2) has submitted a completed application, on such forms as the department may require, with a fee of thirty-seven dollars and fifty cents. No physician [or osteopathic physician] shall function as a supervising physician unless so registered with the department. The department shall not register any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint in this or any other state or territory.

(b) A physician [or osteopathic physician] may function as a supervising physician for as many physician assistants as is medically appropriate under the circumstances, provided (1) the supervision is active and direct, and at the specific location in which the physician assistant is practicing, and (2) the physician is supervising not more than six full-time physician assistants concurrently, or the part-time equivalent thereof.

(c) Nothing in this chapter shall be construed to prohibit the employment of physician assistants in a hospital or other health care facility where such physician assistants function under the direction of a supervising physician.

(d) A supervising physician shall notify the department in writing within thirty days of termination of a physician-physician assistant [or osteopathic-physician assistant] supervisory relationship. Nothing in this subsection shall relieve a supervising physician of his responsibility to report pursuant to section 20-12e.

Sec. 9. Section 20-12d of the general statutes is repealed and the following is substituted in lieu thereof:

(a) A physician assistant who has complied with the provisions of sections 20-12b and 20-12c may perform medical functions delegated [to him] by a supervising physician when: (1) The supervising physician [has] is satisfied [himself] as to the ability and competency of the physician assistant; (2) such delegation is consistent with the health and welfare of the patient and in keeping with sound medical practice; and (3) when such functions are performed under the oversight, control and direction of the supervising physician. The functions [which] that may be performed under such delegation are those [which] that are within the scope of the supervising physician's license, within the scope of such physician's competence as evidenced by such physician's postgraduate education, training and experience and within the normal scope of such physician's actual practice. Delegated functions shall be implemented in accordance with written protocols established by the supervising physician. All orders written by physician assistants shall be followed by the signature of the physician assistant and the printed name of the supervising physician. A physician assistant may, as delegated by the supervising physician within the scope of such physician's license, prescribe and administer drugs, including controlled substances in schedule IV or V; except that a physician assistant may, as delegated by the supervising physician within the scope of such physician's license, prescribe and administer drugs, including controlled substances in schedule II, III, IV, or V to an inpatient in a short-term hospital as defined in the regulations of Connecticut state agencies and licensed pursuant to subsection (a) of section 19a-491 provided in all cases where the physician assistant prescribes a controlled substance in schedule II or III, the physician [or osteopathic physician] under whose supervision the physician assistant is prescribing shall cosign the order not later than twenty-four hours thereafter. The physician assistant may, as delegated by the supervising physician within the scope of such physician's license, dispense drugs, in the form of professional samples as defined in section 20-14c or when dispensing in an outpatient clinic as defined in the regulations of Connecticut state agencies and licensed pursuant to subsection (a) of section 19a-491 [which] that operates on a not-for-profit basis, or when dispensing in a clinic operated by a state agency or municipality. Nothing in this subsection shall be construed to allow the physician assistant to dispense any drug [which] the physician assistant is not authorized under this subsection to prescribe.

(b) All prescription forms used by physician assistants shall contain the printed name, license number, address and telephone number of the physician [or osteopathic physician] under whose supervision the physician assistant is prescribing, in addition to the signature, name, address and license number of the physician assistant.

(c) No physician assistant [shall engage] may: (1) Engage in the independent practice of medicine; [or osteopathy, nor shall a physician assistant represent himself or allow himself to be] (2) claim to be or allow being represented as a physician licensed pursuant to this chapter; [or as an osteopathic physician licensed pursuant to chapter 371, nor shall he] (3) use the title of doctor; [nor shall he associate or allow to be associated with his name any term which would suggest that he is qualified] or (4) associate by name or allow association by name with any term that would suggest qualification to engage in the independent practice of medicine. [or osteopathy.] The physician assistant shall be clearly [identify himself] identified by appropriate identification as a physician assistant to ensure that [he] the physician assistant is not mistaken for a physician licensed pursuant to this chapter. [or an osteopathic physician licensed pursuant to chapter 371.]

(d) A physician assistant licensed under this chapter may make the actual determination and pronouncement of death of a patient, provided: (1) The death is an anticipated death; (2) the physician assistant attests to such pronouncement on the certificate of death; and (3) a physician [or osteopathic physician] licensed by the state of Connecticut certifies the death and signs the certificate of death within twenty-four hours of the pronouncement by the physician assistant.

Sec. 10. Subsection (a) of section 20-12e of the general statutes is repealed and the following is substituted in lieu thereof:

(a) The state or county medical or osteopathic medical society or any state professional organization of physician assistants or any physician, [osteopathic physician,] physician assistant or holder of a permit issued pursuant to section 20-12h or subsection (d) of section 20-12b or any hospital shall within thirty days, and the board or any individual may, file a petition when such society, organization, practitioner, hospital, board or individual has any information that appears to show that a physician assistant is or may be unable to practice as a physician assistant with reasonable skill or safety for any of the reasons listed in section 20-12f. Petitions shall be filed with the department.

Sec. 11. Section 20-13a of the general statutes is repealed and the following is substituted in lieu thereof:

As used in sections 20-13a to 20-13i, inclusive, unless the context otherwise requires:

(1) "Board" means the Connecticut Medical Examining Board, as provided for in section 20-8a;

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

(3) "County society" means a county medical association affiliated with the Connecticut State Medical Society; [or the Connecticut Osteopathic Medical Society;]

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

(5) "License" means any license or permit issued pursuant to section 20-10, 20-11a or 20-12;

(6) "Physician" means a person holding a license issued pursuant to this chapter, except a homeopathic physician; and

(7) "State society" means the Connecticut State Medical Society or the Connecticut Osteopathic Medical Society.

Sec. 12. Section 10-208a of the general statutes is repealed and the following is substituted in lieu thereof:

Each local and regional board of education shall honor written notice submitted by a licensed practitioner of the healing arts, as defined in section 20-1, which places physical restrictions upon any pupil enrolled in the public schools of such board of education. For purposes of this section, licensed practitioner means any person who is licensed to practice under chapter 370, [371,] 372, 373 or 375.

Sec. 13. Subsection (b) of section 17a-101 of the general statutes is repealed and the following is substituted in lieu thereof:

(b) The following persons shall be mandated reporters: Any physician or surgeon licensed under the provisions of chapter 370, [or 371,] any resident physician or intern in any hospital in this state, whether or not so licensed, and any registered nurse, licensed practical nurse, medical examiner, dentist, dental hygienist, psychologist, school teacher, school principal, school guidance counselor, school paraprofessional, social worker, police officer, clergyman, pharmacist, physical therapist, [osteopath,] optometrist, chiropractor, podiatrist, mental health professional or physician assistant, any person who is a licensed substance abuse counselor, any person who is a licensed marital and family therapist, any person who is a sexual assault counselor or a battered women's counselor as defined in section 52-146k or any person paid to care for a child in any public or private facility, day care center or family day care home [which is] licensed by the state.

Sec. 14. Subsection (a) of section 17b-407 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Any physician or surgeon licensed under the provisions of chapter 370, [or 371,] any resident physician or intern in any hospital in this state, whether or not so licensed, and any registered nurse, licensed practical nurse, medical examiner, dentist, [osteopath,] optometrist, chiropractor, podiatrist, social worker, clergyman, police officer, pharmacist, physical therapist, nursing home facility administrator, [nurses] nurse's aide or orderly in a nursing home facility, any person paid for caring for a patient in a nursing home facility, any staff person employed by a nursing home facility, any regional ombudsman or patients' advocate and any person who is a sexual assault counselor or a battered women's counselor as defined in section 52-146k who has reasonable cause to suspect or believe that a patient in a nursing home facility has been abused, neglected, exploited or abandoned, or is in a condition [which] that is the result of such abuse, neglect, exploitation or abandonment, shall within five calendar days report such information or cause a report to be made in any reasonable manner to the Nursing Home Ombudsmen Office. Any person required to report under the provision of this section who fails to make such report within the prescribed time period shall be fined not more than five hundred dollars.

Sec. 15. Subsection (a) of section 17b-451 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Any physician or surgeon licensed under the provisions of chapter 370, [or 371,] any resident physician or intern in any hospital in this state, whether or not so licensed, any registered nurse, any nursing home administrator, nurse's aide or orderly in a nursing home facility, any person paid for caring for a patient in a nursing home facility, any staff person employed by a nursing home facility, any patients' advocate and any licensed practical nurse, medical examiner, dentist, [osteopath,] optometrist, chiropractor, podiatrist, social worker, clergyman, police officer, pharmacist or physical therapist, who has reasonable cause to suspect or believe that any elderly person has been abused, neglected, exploited or abandoned, or is in a condition which is the result of such abuse, neglect, exploitation or abandonment, or who is in need of protective services, shall within five calendar days report such information or cause a report to be made in any reasonable manner to the Commissioner of Social Services or to the person or persons designated by [him] the commissioner to receive such reports. Any person required to report under the provisions of this section who fails to make such report shall be fined not more than five hundred dollars.

Sec. 16. Section 19a-53 of the general statutes is repealed and the following is substituted in lieu thereof:

Each person licensed to practice medicine, surgery, [osteopathy,] midwifery, chiropractic, natureopathy, podiatry or nursing or to use any other means or agencies to treat, prescribe for, heal or otherwise alleviate deformity, ailment, disease or any other form of human ills, who has professional knowledge that any child under five years of age has any physical defect shall, within forty-eight hours from the time of acquiring such knowledge, mail to the Department of Public Health a report, stating the name and address of the child, the name and address of [his] the child's parents or guardians, the nature of the physical defect and such other information as may reasonably be required by [said] the department. [Said] The department shall prepare and furnish suitable blanks in duplicate for such reports, shall keep each report on file for at least six years from the receipt thereof and shall furnish a copy thereof to the State Board of Education within ten days.

Sec. 17. Subsection (b) of section 19a-88 of the general statutes is repealed and the following is substituted in lieu thereof:

(b) Each person holding a license to practice medicine, surgery, [osteopathy,] podiatry, chiropractic or natureopathy shall, annually, during the month of [his] the 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 name in full, his residence and business address and such other information as the department requests.

Sec. 18. Section 19a-92a of the general statutes is repealed and the following is substituted in lieu thereof:

(a) For the purposes of this section:

(1) "Advanced practice registered nurse" means a person licensed to perform advanced level nursing practice activities pursuant to subsection (b) of section 20-87a.

[(2) "Osteopathic physician" means a person licensed to practice osteopathy pursuant to chapter 371.]

[(3)] (2) "Physician" means a person licensed to practice medicine and surgery pursuant to chapter 370.

[(4)] (3) "Physician assistant" means a person licensed pursuant to section 20-12b.

[(5)] (4) "Registered nurse" means a person licensed to practice nursing pursuant to subsection (a) of section 20-87a.

[(6)] (5) "Tattooing" means marking or coloring, in an indelible manner, the skin of any person by pricking in coloring matter or by producing scars.

(b) No person shall engage in tattooing except a physician, [an osteopathic physician,] an advanced practice registered nurse rendering service under the direction of a physician, [or osteopathic physician,] a registered nurse rendering service under the supervision, control and responsibility of a physician, [or osteopathic physician,] a physician assistant rendering service under the supervision, control and responsibility of a physician, or a technician rendering service under the supervision of a physician [or osteopathic physician] in accordance with regulations adopted by the Department of Public Health pursuant to subsection (d) of this section.

(c) No person shall tattoo an unemancipated minor under eighteen years of age without the permission of the parent or guardian of such minor.

(d) The Department of Public Health shall, in accordance with chapter 54, adopt such regulations as are necessary to implement the provisions of this section.

(e) Any person who violates any provision of this section shall be fined not more than one hundred dollars or imprisoned not more than ninety days, or both.

Sec. 19. Subdivision (8) of section 19a-279a of the general statutes is repealed and the following is substituted in lieu thereof:

(8) "Physician" or "surgeon" means a person licensed to practice medicine and surgery [or osteopathy and surgery] under chapter 370 [or 371] or the law of any other state.

Sec. 20. Section 20-14c of the general statutes is repealed and the following is substituted in lieu thereof:

As used in this section and sections 20-14d to 20-14g, inclusive, and section 20-12d:

(1) "Dispense" means dispense, as defined in subdivision (9) of section 20-571.

(2) "Drug" means a legend drug, as defined in section 20-571, or a controlled drug, as defined in subdivision (8) of section 21a-240.

(3) "Prescribing practitioner" means a physician, dentist, podiatrist, optometrist, [osteopath,] physician assistant, advanced practice registered nurse, nurse-midwife or veterinarian licensed by the state of Connecticut and authorized to prescribe medication within the scope of [his] the person's practice.

(4) "Professional samples" means complimentary starter dose drugs packaged in accordance with federal and state statutes and regulations [which] that are provided to a prescribing practitioner free of charge by a manufacturer or distributor and distributed to patients free of charge by the prescribing practitioner. [to his patients.]

Sec. 21. Section 20-14k of the general statutes is repealed and the following is substituted in lieu thereof:

Any physician licensed under this chapter [or chapter 371] shall post, in a conspicuous place, [his] the policy regarding Medicare assignment and shall inform all eligible persons of such policy prior to the delivery of care and services. The Commissioner of Social Services shall adopt regulations in accordance with the provisions of chapter 54 for purposes of this section.

Sec. 22. Section 20-50 of the general statutes is repealed and the following is substituted in lieu thereof:

"Podiatric medicine" means the diagnosis and treatment, including medical and surgical treatment, of ailments of the foot and the anatomical structures of the foot and the administration and prescription of drugs incidental thereto. It shall include treatment of local manifestations of systemic diseases as they appear on the foot. A doctor of podiatric medicine, licensed pursuant to this chapter may prescribe, administer and dispense drugs and controlled substances in schedule II, III, IV or V, in accordance with [subsection (d) of] section 21a-252, in connection with the practice of podiatric medicine.

Sec. 23. Section 20-65 of the general statutes is repealed and the following is substituted in lieu thereof:

Any person, except a licensed podiatrist, [a licensed osteopathic physician,] a licensed natureopathic physician or a physician licensed to practice medicine or surgery, who practices or attempts to practice podiatry, or any person who buys, sells or fraudulently obtains any diploma or license to practice podiatry, or any person who uses the title "podiatrist" or any word or title to induce the belief that [he] such person is engaged in the practice of podiatry, without complying with the provisions of this chapter, upon the first conviction shall be fined not more than five hundred dollars or imprisoned not more than five years or be both fined and imprisoned, [; provided] except that nothing herein contained shall be construed to prohibit or restrict the sale or fitting of corrective, orthopedic or arch-supporting shoes or commercial foot appliances by retail merchants and [provided] no such retail merchant shall be permitted to practice podiatry without being licensed for such practice. For the purposes of this section, each instance of patient contact or consultation [which] that is in violation of any provision of this chapter shall constitute a separate offense. Failure to renew a license in a timely manner shall not constitute a violation for the purposes of this section.

Sec. 24. Subsection (a) of section 20-73 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) No person [who is not licensed by the Department of Public Health as a] may practice as a physical therapist [shall practice or hold himself out as authorized to practice physical therapy as defined in section 20-66, or represent himself as being so registered or licensed or use in connection with his name the term] unless licensed pursuant to this chapter. No person may use the term "Registered Physical Therapist", "Licensed Physical Therapist" or "Physical Therapist" or the letters "R.P.T.", "L.P.T." or any other letters, words or insignia indicating or implying [that he is a licensed] licensure as a physical therapist in this state unless the person is so licensed. The treatment of human ailments by physical therapy shall only be performed by a person licensed under the provisions of this chapter as a physical therapist upon the oral or written referral of a person licensed in this state or in a bordering state having licensing requirements meeting the approval of the appropriate examining board in this state to practice medicine and surgery, [osteopathy,] podiatry, natureopathy, chiropractic or dentistry, or 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. Any person who violates the provisions of this section or who obtains or attempts to obtain licensure as a physical therapist by any wilful misrepresentation or any fraudulent representation shall be fined not more than five hundred dollars or imprisoned not more than five years, or both. A physical therapist or dentist who violates the provisions of this section shall be subject to licensure revocation [of his license] in the same manner as is provided under section 19a-17, or in the case of a healing arts practitioner, section 20-45. For purposes of this section each instance of patient contact or consultation [which is] in violation of any provision of this section shall constitute a separate offense. Failure to renew a license in a timely manner shall not constitute a violation for the purposes of this section.

Sec. 25. Section 20-73a of the general statutes is repealed and the following is substituted in lieu thereof:

The Board of Examiners for Physical Therapists shall have jurisdiction to hear all charges of conduct [which] that fails to conform to the accepted standards of the practice of physical therapy brought against any person licensed as a physical therapist and, after holding a hearing, written notice of which shall be given the person complained of, said board, if it finds such person to be guilty, may revoke or suspend [his] such person's license or take any of the actions set forth in section 19a-17. Any proceedings relative to such action may be begun by the filing of written charges with the Commissioner of Public Health. The causes for which such action may be taken are as follows: Conviction in a court of competent jurisdiction, either within or without this state, of any crime in the practice of his profession; illegal, incompetent or negligent conduct in the practice of physical therapy or in the supervision of a physical therapist assistant; aiding or abetting the unlawful practice of physical therapy; treating human ailments by physical therapy without the oral or written referral by a person licensed in this state or in a bordering state having licensing requirements meeting the approval of the appropriate examining board in this state to practice medicine and surgery, [osteopathy,] podiatry, natureopathy, chiropractic or dentistry; failure to register with the Department of Public Health as required by law; fraud or deception in obtaining a license; engaging in fraud or material deception in the course of professional services or activities; or violation of any provision of this chapter, or any regulation adopted hereunder. The clerk of any court in this state in which a person practicing physical therapy has been convicted of any crime as described in this section shall, immediately after such conviction, transmit a certified copy, in duplicate, of the information and judgment, without charge, to the Department of Public Health, containing the name and address of the physical therapist, the crime of which he has been convicted and the date of conviction. The hearing on such charges shall be conducted in accordance with the regulations adopted by the Commissioner of Public Health. Any person aggrieved by a final decision of said board may appeal therefrom as provided in section 4-183. Such appeal shall have precedence over nonprivileged cases in respect to order of trial. The Attorney General shall act as attorney in the public interest in defending against such an appeal. The board may petition the superior court for the judicial district of Hartford to enforce any action taken pursuant to section 19a-17.

Sec. 26. Section 20-74 of the general statutes is repealed and the following is substituted in lieu thereof:

No provision of this chapter shall confer any authority to practice medicine or surgery, nor shall this chapter prohibit the incidental care of the sick by domestic servants or by persons principally employed as housekeepers or as athletic trainers, nor prohibit any person from the domestic administration of family remedies or the furnishing of assistance in the case of emergency. It shall not prohibit persons registered under the provisions of chapter [371,] 372, 373, 375 or 378 from administering care to patients, nor shall it prohibit the care of the sick with or without compensation or personal profit in connection with the practice of the religious tenets of any church by adherents thereof, provided such persons shall not otherwise engage in the practice of physical therapy within the meaning of this chapter. It shall not prohibit students who are enrolled in schools or courses of physical therapy or physical therapist assistant programs approved by the Board of Examiners for Physical Therapists with the consent of the Commissioner of Public Health from performing such work as is incidental to their respective courses of study; nor shall it prohibit any physical therapist from another state from doing such therapist's work or other physical therapy activities as is incidental to [his] the person's course of study when taking or giving a postgraduate course or other courses of study in this state [which is] approved by said board. It shall not prohibit any person who is a physical therapist assistant from assisting in the practice of physical therapy under the supervision of a licensed physical therapist provided such assistance is limited to the treatment of a person by the employment of the effective properties of physical measures and the use of therapeutic exercises and rehabilitative procedures, with or without assistive devices, for the purpose of preventing, correcting or alleviating a physical or mental disability, and does not include the interpretation of referrals, initial or discharge evaluation or assessment, or determination or modification of treatment or discharge plans. Any physical therapist who is a graduate from a school approved by said board of examiners with the consent of the [Commissioner] Department of Public Health but not licensed in this state may, with the approval of said department and upon obtaining a temporary certificate from said department, practice physical therapy in this state on a temporary basis for a period of six months, which period may be extended upon request at the discretion of the department, provided (1) such physical therapist [shall not represent himself as being] does not claim to be licensed to practice in this state, and (2) application for licensure by examination, reciprocity or endorsement [shall be] is filed with said department within six months after starting such practice. Persons in the service of the federal government are excluded from the provisions of this chapter. For the purposes of this section, supervision means the overseeing of or the participation in the work of a physical therapist assistant by a licensed physical therapist including but not limited to (1) continuous availability of direct communication between the physical therapist assistant and a licensed physical therapist; (2) availability of a licensed physical therapist on a regularly scheduled basis to (A) review the practice of the physical therapist assistant, and (B) support the physical therapist assistant in the performance of his services; and (3) a predetermined plan for emergency situations, including the designation of an alternate licensed physical therapist in the absence of the regular licensed physical therapist.

Sec. 27. Subsection (c) of section 20-74bb of the general statutes is repealed and the following is substituted in lieu thereof:

(c) A radiographer licensed pursuant to subsection (c) of section 19a-14 and sections 20-74aa to 20-74cc, inclusive, and 20-74ee [shall] may operate a medical x-ray system under the supervision and upon the written order of a physician licensed pursuant to chapter 370, [an osteopathic physician licensed pursuant to chapter 371,] a chiropractor licensed pursuant to chapter 372, a natureopath licensed pursuant to chapter 373, a podiatrist licensed pursuant to chapter 375, a dentist licensed pursuant to chapter 379 or a veterinarian licensed pursuant to chapter 384.

Sec. 28. Subsection (a) of section 20-74ee of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Nothing in subsection (c) of section 19a-14, sections 20-74aa to 20-74cc, inclusive, and this section shall be construed to require licensure as a radiographer or to limit the activities of a physician licensed pursuant to chapter 370, [an osteopathic physician licensed pursuant to chapter 371,] a chiropractor licensed pursuant to chapter 372, a natureopath licensed pursuant to chapter 373, a podiatrist licensed pursuant to chapter 375, a dentist licensed pursuant to chapter 379 or a veterinarian licensed pursuant to chapter 384. Nothing in subsection (c) of section 19a-14, sections 20-74aa to 20-74cc, inclusive, and this section shall be construed to require licensure as a radiographer or to limit the activities of a dental hygienist licensed pursuant to chapter 379 provided that such dental hygienist is engaged in the taking of dental x-rays under the general supervision of a dentist licensed pursuant to chapter 379. Nothing in subsection (c) of section 19a-14, sections 20-74aa to 20-74cc, inclusive, and this section shall be construed to require licensure as a radiographer or to limit the activities of a dental assistant as defined in section 20-112a, provided such dental assistant is engaged in the taking of dental x-rays under the supervision and control of a dentist licensed pursuant to chapter 379 and can demonstrate by January 1, 1996, successful completion of the dental radiography portion of an examination prescribed by the Dental Assisting National Board. Nothing in subsection (c) of section 19a-14, sections 20-74aa to 20-74cc, inclusive, and this section shall be construed to require licensure as a radiographer or to limit the activities of a Nuclear Medicine Technologist certified by the Nuclear Medicine Technology Certification Board or the American Registry of Radiologic Technologists, provided such individual is engaged in the operation of a bone densitometry system under the supervision, control and responsibility of a physician licensed pursuant to chapter 370. [or an osteopathic physician licensed pursuant to chapter 371.]

Sec. 29. Subsections (b) and (c) of section 20-162n of the general statutes are repealed and the following is substituted in lieu thereof:

(b) "Respiratory care" means health care under the direction of a physician licensed pursuant to chapter 370 [or an osteopathic physician licensed pursuant to chapter 371] and in accordance with written protocols developed by said physician, employed in the therapy, management, rehabilitation, diagnostic evaluation and care of patients with deficiencies and abnormalities which affect the cardiopulmonary system and associated aspects of other system functions and which includes the following: (1) The therapeutic and diagnostic use of medical gases, administering apparatus, humidification and aerosols, administration of drugs and medications to the cardiorespiratory systems, ventilatory assistance and ventilatory control, postural drainage, chest physiotherapy and breathing exercises, respiratory rehabilitation, cardiopulmonary resuscitation and maintenance of natural airways as well as the insertion and maintenance of artificial airways, (2) the specific testing techniques employed in respiratory therapy to assist in diagnosis, monitoring, treatment and research, including the measurement of ventilatory volumes, pressures and flows, specimen collection of blood and other materials, pulmonary function testing and hemodynamic and other related physiological monitoring of cardiopulmonary systems, and (3) patient education in self-care procedures as part of the ongoing program of respiratory care of such patient. The practice of respiratory therapy is not limited to the hospital setting;

(c) "Respiratory care practitioner" means a person who is licensed to practice respiratory care in this state pursuant to section 20-162o and who may transcribe and implement written and verbal orders for respiratory care [which are] issued by a physician licensed pursuant to chapter 370, [an osteopathic physician licensed pursuant to chapter 371,] or a physician assistant licensed pursuant to chapter 370 or an advanced practice registered nurse licensed pursuant to chapter 378 who is functioning within [his] the person's respective scope of practice.

Sec. 30. Subsection (a) of section 20-195 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Nothing in this chapter shall be construed to limit the activities and services of a graduate student, intern or resident in psychology, pursuing a course of study in an educational institution registered under the provisions of section 20-189, if such activities constitute a part of [his] a supervised course of study. The provisions of this chapter shall not apply to any person in the salaried employ of any person, firm, corporation, educational institution or governmental agency when acting within [his] the person's own organization. Nothing in this chapter shall be construed to prevent the giving of accurate information concerning education and experience by any person in any application for employment. Nothing in this chapter shall be construed to prevent physicians, [osteopaths,] optometrists, chiropractors, members of the clergy, attorneys-at-law or social workers from doing work of a psychological nature consistent with accepted standards in their respective professions.

Sec. 31. Subsection (a) of section 21a-65 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) A licensed manufacturer or licensed wholesaler may sell hypodermic needles and syringes only to the following: (1) To a licensed manufacturer, licensed wholesaler or licensed pharmacy; (2) to a physician, [osteopath,] dentist, veterinarian, embalmer, podiatrist or scientific investigator licensed to practice [his profession] in this state; (3) to a person in charge of a care-giving institution, as defined in subdivision (2) of section 20-571, incorporated college or scientific institution, but only for use by or in such care-giving institution, college or institution for medical or scientific purposes; (4) to a person in charge of a licensed or registered laboratory, but only for use in that laboratory for scientific and medical purposes; (5) to a farmer but only for use on [his] the farmer's own animals or poultry; (6) to a business authorized in accordance with the regulations adopted under section 21a-66 to purchase hypodermic needles and syringes but only for legitimate industrial or medical use within that business; and (7) to a needle and syringe exchange program established pursuant to section 19a-124.

Sec. 32. Subdivisions (40) to (43), inclusive, of section 21a-240 of the general statutes are repealed and the following is substituted in lieu thereof:

(40) "Physician" means a person authorized by law to practice medicine in this state pursuant to [sections] section 20-9; [and 20-21;]

(41) "Podiatrist" means a person authorized by law to practice podiatry in this state;

(42) "Poppy straw" means all parts, except the seeds, of the opium poppy, after mowing;

(43) "Practitioner" means: (A) A physician, dentist, veterinarian, podiatrist, [osteopath,] scientific investigator or other person licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this state; (B) a pharmacy, hospital or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this state.

Sec. 33. Subsection (a) of section 21a-246 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) No person within this state shall manufacture, wholesale, repackage, supply, compound, mix, cultivate or grow, or by other process produce or prepare, controlled substances without first obtaining a license to do so from the Commissioner of Consumer Protection and no person within this state shall operate a laboratory for the purpose of research or analysis using controlled substances without first obtaining a license to do so from the Commissioner of Consumer Protection, [; provided] except that such activities by pharmacists or pharmacies in the filling and dispensing of prescriptions or activities incident thereto, or the dispensing or administering of controlled substances by dentists, [osteopaths,] podiatrists, physicians, veterinarians, or other persons acting under their supervision, in the treatment of patients shall not be subject to the provisions of this section, and provided laboratories for instruction in dentistry, medicine, nursing, pharmacy, pharmacology and pharmacognosy in institutions duly licensed for such purposes in this state shall not be subject to the provisions of this section except with respect to narcotic drugs and schedule I and II controlled substances. Upon application of any physician licensed pursuant to chapter 370, the Commissioner of Consumer Protection shall without unnecessary delay, license such physician to possess and supply marijuana for the treatment of glaucoma or the side effects of chemotherapy. No person without this state shall sell or supply controlled substances within the state without first obtaining a license to do so from the Commissioner of Consumer Protection, provided no such license shall be required of a manufacturer whose principal place of business is located outside the state and who is registered with the federal Drug Enforcement Agency or other federal agency, and who files a copy of such registration with the appropriate licensing authority under this chapter.

Sec. 34. Subsection (a) of section 21a-250 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) A pharmacist, in good faith, may sell and dispense controlled substances to any person upon a prescription of a physician or [of an osteopath,] dentist, podiatrist, optometrist, veterinarian, physician assistant licensed pursuant to section 20-12b, advanced practice registered nurse, or nurse-midwife to the extent that they are authorized to prescribe such controlled substances. Except as otherwise provided by regulations adopted pursuant to section 21a-244, the person filling or refilling the prescription shall include the date of filling and [his] the person's signature or initials on any prescription for controlled substances, and the prescription shall be retained on file by the proprietor of the pharmacy in which it is filled for a period of three years, so as to be readily accessible for inspection by any public officer or employee engaged in the enforcement of this chapter. The prescription shall not be filled or refilled unless permitted by federal food and drug laws, the federal Controlled Substances Act and regulations adopted under this chapter.

Sec. 35. Section 21a-252 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) A physician, in good faith and in the course of [his] the physician's professional practice only, may prescribe, administer and dispense controlled substances, or [he] may cause the same to be administered by a physician assistant, nurse or intern under [his] the physician's direction and supervision, for demonstrable physical or mental disorders but not for drug dependence except in accordance with state and federal laws and regulations adopted thereunder. Notwithstanding the provisions of this subsection the Department of Consumer Protection may approve protocols allowing the dispensing of take-home doses of methadone, by a registered nurse or licensed practical nurse, to outpatients in duly licensed substance abuse treatment facilities. Such dispensing shall be done pursuant to the order of a licensed prescribing practitioner and using computerized dispensing equipment into which bulk supplies of methadone are dispensed by a pharmacist. The quantity of methadone dispensed by such nurse shall not exceed at any one time that amount allowed under federal or state statutes or regulations governing the treatment of drug dependent patients. The Department of Consumer Protection shall conduct inspections of such treatment facilities to ensure that the computerized dispensing equipment and related dispensing procedures documented in the approved protocols are adhered to.

[(b) An osteopath, in good faith and in the course of his professional practice only, may prescribe, administer or dispense controlled substances, or he may cause the same to be administered by a nurse under his direction and supervision, for relief of pain to the extent permitted by the federal Controlled Substances Act and state laws and regulations relating to osteopathy.]

[(c)] (b) A dentist, in good faith and in the course of [his] the dentist's professional practice only, may prescribe, administer or dispense controlled substances, or [he] may cause the same to be administered by a nurse under [his] the dentist's direction and supervision, to the extent permitted by the federal Controlled Substances Act, federal food and drug laws and state laws and regulations relating to dentistry.

[(d)] (c) A podiatrist, in good faith and in the course of [his] the podiatrist's professional practice only, may prescribe, administer and dispense controlled substances in schedules II, III, IV or V, or [he] may cause the same to be administered by a nurse under [his] the podiatrist's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to podiatry.

[(e)] (d) A veterinarian, in good faith in the course of [his] the veterinarian's professional practice only, and not for use by a human being, may prescribe, administer and dispense controlled substances, and [he] may cause them to be administered by an assistant or orderly under [his] the veterinarian's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to veterinary medicine.

[(f)] (e) An advanced practice registered nurse licensed pursuant to section 20-94a, in good faith and in the course of [his] such nurse's professional practice only, may prescribe, dispense, and administer controlled substances in schedule II, III, IV or V, or may cause the same to be administered by a registered nurse or licensed practical nurse under [his] the advanced practice registered nurse's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to advanced nursing practice.

[(g)] (f) A nurse-midwife licensed under chapter 377, in good faith and in the course of [his] the nurse-midwife's professional practice only, may prescribe, dispense, and administer controlled substances in schedules II, III, IV and V, or [he] may cause the same to be administered by a registered nurse or licensed practical nurse under [his] the nurse-midwife's direction and supervision, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws.

[(h)] (g) A physician assistant licensed pursuant to section 20-12b, in good faith and in the course of [his] the physician assistant's professional practice only, may prescribe, dispense, and administer controlled substances in schedule II, III, IV or V, or may cause the same to be administered by an advanced practice registered nurse, registered nurse, or licensed practical nurse who is acting under a physician's direction, to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to physician assistant practice.

[(i)] (h) An optometrist authorized to practice advanced optometrical care, in good faith and in the course of [his] the optometrist's professional practice only and who is duly authorized by section 20-127, may prescribe, administer or dispense controlled substances in schedule II, III, IV or V to the extent permitted by the federal Controlled Substances Act, the federal food and drug laws and state laws and regulations relating to optometry.

[(j)] (i) Any person who has obtained directly from a physician, [osteopath,] dentist, podiatrist, optometrist, veterinarian, physician assistant, advanced practice registered nurse or nurse-midwife any controlled substance for [administration to himself or] self-administration or administration to a patient during the absence of such physician, [osteopath,] dentist, podiatrist, optometrist, veterinarian, physician assistant, advanced practice registered nurse or nurse-midwife shall return to such physician, [osteopath,] dentist, podiatrist, optometrist, veterinarian, physician assistant, advanced practice registered nurse or nurse-midwife any unused portion of such controlled substance, when it is no longer required by [him] the person or the patient, or [he] may surrender such controlled substance to the Commissioner of Consumer Protection for proper disposition.

Sec. 36. Subsection (b) of section 21a-256 of the general statutes is repealed and the following is substituted in lieu thereof:

(b) When a pharmacist sells or dispenses any controlled substance on prescription issued by a physician, advanced practice registered nurse, physician assistant, podiatrist, [osteopath,] dentist or veterinarian, [he] the pharmacist shall affix, to the container in which such substance is sold or dispensed, a label showing the name and address of the pharmacy for which [he] the pharmacist is lawfully acting, the full name of the patient, or, if the patient is an animal, the name of the owner of the animal and the species of the animal, the last name of the physician, advanced practice registered nurse, physician assistant, [osteopath,] podiatrist, dentist or veterinarian by whom the prescription was written, such directions as may be stated on the prescription, the serial number of the prescription, the date of filling or refilling and any cautionary statement in such prescription as may be required by law.

Sec. 37. Section 21a-257 of the general statutes is repealed and the following is substituted in lieu thereof:

A person to whom or for whose use any narcotic drug has been prescribed, sold or dispensed by a physician, [osteopath,] dentist, pharmacist or other person authorized under the provisions of section 21a-248, and the owner of any animal for which any such drug has been prescribed, sold or dispensed may lawfully possess it only in the container in which it was delivered to [him] the recipient by the person selling or dispensing the same except as may be authorized by regulations adopted hereunder.

Sec. 38. Subsection (d) of section 21a-266 of the general statutes is repealed and the following is substituted in lieu thereof:

(d) No person shall, for the purpose of obtaining a controlled substance, falsely assume the title of, or [represent himself] claim to be, a manufacturer, wholesaler, pharmacist, physician, dentist, [osteopath,] veterinarian, podiatrist or other authorized person.

Sec. 39. Section 21a-316 of the general statutes is repealed and the following is substituted in lieu thereof:

As used in this chapter, "practitioner" means: (1) A physician, dentist, veterinarian, podiatrist, [osteopath,] optometrist, physician assistant licensed pursuant to section 20-12b, advanced practice registered nurse as defined in subsection (b) of section 20-87a, nurse-midwife, scientific investigator or other person licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this state; (2) a hospital or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this state.

Sec. 40. Section 22a-150 of the general statutes is repealed and the following is substituted in lieu thereof:

The Commissioner of Environmental Protection shall, by regulation, require registration of devices emitting x-rays [which are] used for diagnostic or therapeutic purposes by or under the supervision of a person or persons licensed to practice medicine, surgery, [osteopathy,] chiropractic, natureopathy, dentistry, podiatry or veterinary medicine and surgery, as authorized by law. The commissioner shall charge a registration fee of seventy-five dollars biennially for each such device, except that hospitals operated by the state or a municipality shall be exempt from payment of the fee. The commissioner may adopt regulations, in accordance with the provisions of chapter 54, to prescribe the amount of the fees required pursuant to this section. Upon the adoption of such regulations, the fees required by this section shall be as prescribed in such regulations.

Sec. 41. Subdivision (17) of section 31-275 of the general statutes is repealed and the following is substituted in lieu thereof:

(17) "Physician" includes any person licensed and authorized to practice a healing art, as defined in section 20-1, and licensed under the provisions of chapters 370, [371,] 372 and 373 to practice in this state.

Sec. 42. Subdivision (1) of section 33-182a of the general statutes is repealed and the following is substituted in lieu thereof:

(1) "Professional service" means any type of service to the public [which] that requires that members of a profession rendering such service obtain a license or other legal authorization as a condition precedent to the rendition thereof, limited to the professional services rendered by dentists, natureopaths, [osteopaths,] chiropractors, physicians and surgeons, doctors of dentistry, physical therapists, occupational therapists, podiatrists, optometrists, nurses, nurse-midwives, veterinarians, pharmacists, architects, professional engineers, or jointly by architects and professional engineers, landscape architects, certified public accountants and public accountants, land surveyors, psychologists, attorneys-at-law, licensed marital and family therapists and licensed clinical social workers.

Sec. 43. Subdivision (17) of section 34-101 of the general statutes is repealed and the following is substituted in lieu thereof:

(17) "Professional service" means any type of service to the public [which] that requires that members of a profession rendering such service obtain a license or other legal authorization as a condition precedent to the rendition thereof, limited to the professional services rendered by dentists, natureopaths, [osteopaths,] chiropractors, physicians and surgeons, doctors of dentistry, physical therapists, occupational therapists, podiatrists, optometrists, nurses, nurse-midwives, veterinarians, pharmacists, architects, professional engineers, or jointly by architects and professional engineers, landscape architects, certified public accountants and public accountants, land surveyors, psychologists, attorneys-at-law, licensed marital and family therapists and licensed clinical social workers.

Sec. 44. Subsection (b) of section 38a-393 of the general statutes is repealed and the following is substituted in lieu thereof:

(b) For purposes of sections 38a-393 to 38a-395, inclusive, "professional liability insurance" means professional liability contracts for: (1) Physicians and surgeons, (2) hospitals, (3) lawyers, (4) dentists, (5) architects and engineers, [(6) osteopathic physicians, (7)] (6) chiropractors, [(8)] (7) licensed natureopaths, and [(9)] (8) podiatrists and such other categories as the Insurance Commissioner, in [his] the commissioner's discretion, shall adopt by regulations in accordance with chapter 54.

Sec. 45. Subsection (g) of section 38a-551 of the general statutes is repealed and the following is substituted in lieu thereof:

(g) "Physician" means a doctor of medicine, [osteopathy,] chiropractic, natureopathy, podiatry, a qualified psychologist and, for purposes of oral surgery only, a doctor of dental surgery or a doctor of medical dentistry [,] and, subject to the provisions of section 20-138d, optometrists duly licensed under the provisions of chapter 380.

Sec. 46. Subsection (a) of section 46a-11b of the general statutes is repealed and the following is substituted in lieu thereof:

(a) Any physician or surgeon licensed under the provisions of chapter 370, [or 371,] any resident physician or intern in any hospital in this state, whether or not so licensed, any registered nurse, any person paid for caring for persons in any facility and any licensed practical nurse, medical examiner, dental hygienist, dentist, occupational therapist, [osteopath,] optometrist, chiropractor, psychologist, podiatrist, social worker, school teacher, school principal, school guidance counselor, school paraprofessional, mental health professional, physician assistant, [Connecticut] licensed or certified substance abuse counselor, licensed marital and family therapist, speech pathologist, clergyman, police officer, pharmacist, physical therapist or sexual assault counselor or battered women's counselor as defined in section 52-146k who has reasonable cause to suspect or believe that any person with mental retardation has been abused or neglected shall, within five calendar days, report such information or cause a report to be made in any reasonable manner to the director or persons [designated by him] the director designates to receive such reports. Such report shall be followed up by a written report within five additional calendar days. Any person required to report under this subsection who fails to make such report shall be fined not more than five hundred dollars.

Sec. 47. Section 52-149a of the general statutes is repealed and the following is substituted in lieu thereof:

(a) The deposition of any physician, psychologist, chiropractor, natureopathic physician [, osteopathic physician] or dentist licensed under the provisions of the general statutes, may be taken on behalf of either party to any civil action, workers' compensation matter or probate proceeding, in which the physician, psychologist, chiropractor, natureopathic physician [, osteopathic physician] or dentist may be called as an expert witness, on notice by certified mail to each adverse party or [his] the party's attorney, as the case may be. The deposition may be received in evidence at the trial or hearing of the civil action, workers' compensation matter or probate proceeding in lieu of the appearance of the witness in court or at the hearing. The deposition may be taken by stenographic means, videotape or in such other manner as may be provided by rule of court or of the compensation commissioners.

(b) Whenever the deposition of a physician, psychologist, chiropractor, natureopathic physician [, osteopathic physician] or dentist is so taken, the party requesting the deposition shall pay to the medical expert the fee for giving testimony for the deposition.

Sec. 48. Section 52-174 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) In all actions for the recovery of damages for personal injuries or death, (1) if a physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician, optometrist, professional engineer or land surveyor has died prior to the trial of the action, or (2) if a physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician, optometrist, professional engineer or land surveyor is physically or mentally disabled at the time of the trial of the action to such an extent that [he] such person is no longer actively engaged in the practice of [his] the profession, the party desiring to offer into evidence the written records and reports of the physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist concerning the patient who suffered the injuries or death and the reports and scale drawings of the professional engineer or land surveyor concerning matter relevant to the circumstances under which the injuries or death was sustained shall apply to the court in which the action is pending for permission to introduce the evidence. Notice of the application shall be served on the adverse party in the same manner as any other pleading. The court to which the application is made shall determine whether the person is disabled to the extent that [he] the person cannot testify in person in the action. Upon the court finding that the person is so disabled, the matters shall be admissible in evidence as a business entry in accordance with the provisions of section 52-180 when offered by any party in the trial of the action.

(b) In all actions for the recovery of damages for personal injuries or death, pending on October 1, 1977, or brought thereafter, and in all court proceedings in family relations matters, as defined in section 46b-1, or in the Family Support Magistrate Division, pending on October 1, 1998, or brought thereafter, any party offering in evidence a signed report and bill for treatment of any treating physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist may have the report and bill admitted into evidence as a business entry and it shall be presumed that the signature on the report is that of the treating physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist and that the report and bill were made in the ordinary course of business. The use of any such report or bill in lieu of the testimony of such treating physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist shall not give rise to any adverse inference concerning the testimony or lack of testimony of such treating physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist.

(c) This section shall not be construed as prohibiting either party or the court from calling the treating physician, dentist, chiropractor, [osteopath,] natureopath, physical therapist, podiatrist, psychologist, emergency medical technician or optometrist as a witness.

Sec. 49. Subsection (a) of section 53-212 of the general statutes is repealed and the following is substituted in lieu thereof:

(a) No person, unless [he] such person holds a license to practice medicine and surgery [or a license to practice osteopathy] or a license to practice dentistry, shall use the Roentgen-ray or the x-ray or radium for the therapeutic or cosmetic treatment of another person, unless such person uses the same under the prescription, direction or supervision of a licensed physician, surgeon [, osteopath] or dentist.

Sec. 50. Section 53-341 of the general statutes is repealed and the following is substituted in lieu thereof:

No person engaged in the practice of any branch of the art of healing the sick or injured or professing to be engaged in such practice shall make use of the title "doctor" or any abbreviation thereof without further specification or qualification descriptive of the school or kind of practice engaged in by such person [,] or advertise [himself as possessor of such title, unless he] as possessing such title unless such person has received a degree of doctor of medicine [, doctor of osteopathy] or doctor of dental surgery from a reputable university or college authorized by law to confer such a degree. [; and no] No person who has not been legally licensed or registered to practice any branch of the healing arts in this state shall use or advertise or permit to be used or advertised in connection with [his] such person's name or any trade name in the conduct of any occupation or profession involving or pertaining to public health the title "doctor" or any abbreviation thereof or any designation tending to designate [him as a person capable of the diagnosis, treatment, prevention] the capability to diagnose, treat, prevent or cure of any human disease, pain, injury, deformity or physical condition, actual or imaginary, [; provided] except that any dentist who has received a degree of doctor of dental surgery from a reputable university or college authorized by law to confer such degree and who is licensed to practice dentistry in this state [shall not be prevented from designating himself] may be designated as the possessor of such degree or title. No provision of this section shall apply to any person admitted to practice under the provisions of the medical registration act of 1893. Any person violating any provision of this section shall be fined not more than one hundred dollars or imprisoned not more than sixty days or both.

Sec. 51. (a) Subdivision (2) of subsection (a) of section 2c-2b, subdivision (11) of subsection (b) of section 19a-14, section 20-15, sections 20-17 to 20-23, inclusive, and subdivision (35) of section 21a-240 of the general statutes are repealed.

(b) In codifying the provisions of this act, the Legislative Commissioners shall delete the reference to 20-17 that appears in section 1-1e of the general statutes, the references to sections 20-17 to 20-20, inclusive, that appear in subsection (a) of section 19a-1c of the general statutes, and the reference to section 20-20 that appears in section 51-344a of the general statutes.

Approved June 3, 1999

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