SB 477 — AN ACT CONCERNING THE PUBLIC HEALTH OF RESIDENTS OF THE STATE.

Such minimum staffing requirements shall be prescribed by the department in regulations adopted pursuant to this section, and take effect upon adoption of such regulations.

Each assisted living services agency that provides services as a dementia special care unit or program, as defined in section 19a-562, as amended by this act, shall submit to the Department of Public Health a list of dementia special care units or locations and their staffing plans for any such units and locations when completing an initial or a renewal licensure application, or upon request from the department.

Such staffing plans shall comply with the minimum staffing requirements in regulations prescribed by the department pursuant to this section.

(d) Each assisted living services agency that provides services as a dementia special care unit or program shall post the following information on a daily basis at the beginning of each shift, in a legible format and in a conspicuous place readily accessible to and clearly visible to residents, employees and visitors of the dementia special care unit or location of the dementia special care program, including, but not limited to, persons in a wheelchair:

(1) Name of the assisted living services agency and location of the dementia special care unit or program;

(2) Date;

(3) Total number of (A) advanced practice registered nurses, (B) registered nurses, (C) licensed practical nurses, and (D) nurse's aides who will be responsible for direct patient care during the shift;

(4) Total number of hours such (A) advanced practice registered nurses, (B) registered nurses, (C) licensed practical nurses, and (D) nurse's aides are scheduled to work during the shift;

LCO No.

3789 4 of 13 Raised Bill No.477 (5) Total number of dementia special care unit residents or dementia special care program participants;

(6) The minimum number of nursing home facility staff per shift that is required by the regulations of Connecticut state agencies to be responsible for providing direct patient care to residentsofthedementia special care unit or participants in the dementia special care program;

and (7) The telephone number or Internet web site that a resident, employee or visitor of the dementia special care unit or location of the dementia special care program may use to report a suspected violation by the assisted living services agency of a regulatory requirement concerning staffing levels and direct patient or program participant care.

(e) Each assisted living services agency providing services as a dementia special care unit or program shall, upon oral or written request, make the daily information posted pursuant to subsection (d) of this section available to the public for review.

The assisted living services agency shall retain such information for not less than eighteen months from the date such information was posted.

[(d)] (f) An assisted living services agency shall ensure that (1) all services being provided on an individual basis to [clients] residents are fully understood and agreed upon between either the [client] resident or the [client's] resident's legal representative or responsible party, and (2) the [client or the client's] resident or the resident's legal representative or responsible party are made aware of the cost of any such services.

(g) Each assisted living services agency providing services as a dementia special care unit or program shall maintain a daily record of the following regarding each resident of the unit or participant in the program and make such record available to the Department of Public Health upon request:

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3789 5 of 13 Raised Bill No.477 (1) Type and number of meals served and the times each meal was offered to the resident.

The assisted living services agency shall ensure that the maximum time span between a resident's or participant's evening meal and breakfast does not exceed sixteen hours unless a substantial bedtime nourishment is verbally offered by the assisted living servicesagency, providedtheassistedliving servicesagency shall not be required to serve such nourishment to patients or participants who decline such nourishment;

(2) The time a resident or participant bathed or was offered a bath or was bathed by a staff member of the assisted living services agency;

(3)Themedicationstakenbythepatientorparticipantandtimessuch medications were taken;

and (4) A description of the overall health of the patient or participant.

[(e)] (h) The Department of Public Health [may] shall adopt regulations, in accordance with the provisions of chapter 54, to carryout the purposes of this section.

Sec.

3.

Section 19a-563f of the 2022 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2022):

On or before January 1, 2022, the administrative head of each nursing home and dementia special care unit and, on or before January 1, 2023, the administrative head of each assisted living facility shall encourage the establishment of a family council and assist in any such establishment.

The family council shall facilitate and support open communication between the nursing home, [or] dementia special care unit or assisted living facility and each resident's family members and friends.

As used in this section, "family council" means an independent, self-determining group of the family members and friends of the residents of a nursing home, [or] dementia special care unit or assisted living facility that is geared to meeting the needs and interests of the residents and their family members and friends.

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3789 6 of 13 Raised Bill No.477 Sec.

4.

As used in this subsection,subdivision, "birthing hospital" means a health care facility, as defined in section 19a- 630, operated and maintained in whole or in part for the purpose of caring for patients during the delivery of a child and for a postpartum person and such person's newborn following birth;

5.3.

(NEW) (Effective July 1, 2022) (a) As used in this section, "birthinghospital"means"birthing ahealthcarefacility,asdefinedinsection19a-hospital" 630,means a health care facility, as defined in section 19a- 630 of the general statutes, operated and maintained in whole or in part for the purpose of caring for a person during the delivery of a child and for a postpartum person and such person's newborn following birth.

(b) On and after October 1, 2022, each birthing hospital shall provide to each patient who has undergone a caesarean section written information regarding the importance of mobility following a caesarean section and the risks associated with immobility following a caesarean LCOsSB477 / File No.

3789535 73 ofsSB477 13File RaisedNo. Bill No.477 section.

535 section.

(d) On and after January 1, 2023, each birthing hospital shall provide to each postpartum patient the educational materials regarding the health and safety of pregnant and postpartum persons with mental health disorders, including, but not limited to, perinatal mood and anxiety disorders, developed by the maternal mortality review committee pursuant to subsection (g) of section 19a-51i,19a-59i of the general statutes, as amended by this act.

6.4.

7.5.

(NEW) (Effective from passage) (a) There is established a Commission on Gun Violence Intervention and Prevention to coordinate the funding and implementation of evidence-based, evidenced-informed, community-centric gun programs and strategies LCOsSB477 / File No.

3789535 84 ofsSB477 13File RaisedNo. Bill No.477 to reduce community gun violence in the state.

535 to reduce community gun violence in the state.

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

(5) Two appointed by the minority leader of the House of Representatives, one of whom shall be a representative of Yale New Haven Hospital and one of whom shall be a representative of the Greater Bridgeport Adolescence Program;

LCOsSB477 / File No.

3789535 95 ofsSB477 13File RaisedNo. Bill No.477 (8) Two appointed by the Senate chairperson of the joint standing committee of the General Assembly having cognizance of matters relating to public health, one of whom shall be a representative of Mothers United Against Violence and one of whom shall be a representative of Violent Crime Survivors;

535 (8) Two appointed by the Senate chairperson of the joint standing committee of the General Assembly having cognizance of matters relating to public health, one of whom shall be a representative of Mothers United Against Violence and one of whom shall be a representative of Violent Crime Survivors;

(11)The Commissioner ofEducation,ofEducation,orthecommissioner'sdesignee; orthecommissioner's designee;

(d) The executive director of the Commission on Women, Children, Seniors, Equity and OpportunityOpportunity, or the executive director's designee, shall schedule the first meeting of the commission, which shall be held not later than sixty days after the effective date of this section.

At such meeting, thethechairpersonofthecommissionshallbeelectedfromamong chairperson of the commission shall be elected from among the members of the commission.

(e) If an appointment under subsection (b) of this section is not made within the sixty-day periodperiodrequired required under subsection (c) of this section, LCOthe chairperson may designate an individual with the required sSB477 / File No.

3789535 106 ofsSB477 13File RaisedNo. Bill No.477 the chairperson may designate an individual with the required qualifications stated for the applicable appointment to serve on the commission until an appointment is made pursuant to subsection (b) of this section.

535 qualifications stated for the applicable appointment to serve on the commission until an appointment is made pursuant to subsection (b) of this section.

(4) (A) establish and implement a grant program, and (B) award grants and offer guidance to organizations or LCOother No.entities working toward reducing community gun violence in the state;

3789(5) 11obtain offrom 13any Raisedlegislative Billor executive department, board, sSB477 / File No.

477535 other7 entitiessSB477 workingFile towardNo. reducing community gun violence in the state;

(5)535 obtain from any legislative or executive department, board, commission or other agency of the state or any organization or other entity such assistance as necessary and available to carry out the purposes of this section;

8.6.

Section 1 Octoberfrom 1,passage 2022New 19a-562section Sec.

2 Octoberfrom 1,passage 202219a-59i 19a-564 Sec.

3 July 1, 2022 19a-563fNew section Sec.

4 from passage 19a-59i10-29a(a) Sec.

5 Julyfrom 1,passage 2022 New section Sec.

6 fromJuly passage1, 10-29a(a)2022 Sec.New section Statement of Legislative Commissioners:

7In fromSection passage5(d), Newthe phrase, "or the executive director's designee" was added for consistency with the provisions of section Sec.5(b)(12).

8PH JulyJoint 1,Favorable 2022Subst. New section Statement of Purpose:

TosSB477 address/ theFile publicNo. health needs of residents of the state.

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3789535 12The offollowing 13Fiscal RaisedImpact Statement and Bill No.Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

477In [Proposedgeneral, deletionsfiscal impacts are enclosedbased inupon brackets.a variety of informational sources, including the analyst’s professional knowledge.

ProposedWhenever additionsapplicable, areagency indicateddata byis underline,consulted exceptas thatpart whenof the entireanalysis, texthowever offinal aproducts billdo ornot resolutionnecessarily orreflect aan sectionassessment offrom aany billspecific ordepartment. resolution is new, it is not underlined.] LCO No.

3789OFA 13Fiscal ofNote 13State Impact:

None Municipal Impact:

None Explanation This bill establishes a task force to study assisted living services agencies that provide services as a dementia special care unit or program.

The task force shall submit its findings and recommendations to the Public Health Committee by January 1, 2023.

This bill has no fiscal impact as PA 17-236 prohibits transportation allowances for task force members.

The Out Years State Impact:

None Municipal Impact:

None sSB477 / File No.

535 9 sSB477 File No.

535 OLR Bill Analysis sSB 477 AN ACT CONCERNING THE PUBLIC HEALTH OF RESIDENTS OF THE STATE.

SUMMARY This bill makes the following unrelated changes in the public health statutes:

1.

establishes a nine-member task force to study the regulation and staffing levels of assisted living services agencies (ALSAs) that provide services as dementia special care units or programs and requires the task force to report its findings and recommendations to the Public Health Committee by January 1, (§ 1);

2.

requires the Department of Public Health’s (DPH’s) Maternal Mortality Review Committee to develop educational materials on intimate partner violence and pregnant and postpartum persons with mental health disorders, which DPH must distribute to specified hospitals and health care providers (§ 2);

3.

requires birthing hospitals (a) starting October 1, 2022, to provide caesarean section patients with written information on the importance of mobility following the procedure and (b) starting January 1, 2023, to provide postpartum patients certain educational materials and establish a patient portal for them to virtually access any educational materials and information provided to the patients during their stay or discharge (§ 3);

4.

designates the month of May as “Maternal Mental Health Month” and each May 5 as “Maternal Health Day,” and allows suitable exercises to be held at the Capitol and other locations the sSB477 / File No.

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535 governor designates (§ 4);

5.

establishes a 21-member Commission on Gun Violence Intervention and Prevention within the Legislative Department to coordinate strategies and programs to reduce gun violence in the state and requires the commission to annually report to the Public Health Committee on its activities (§ 5);

and 6.

appropriates $250,000 to DPH in FY 23 to promote the federal Centers for Disease Control and Prevention’s “Hear Her” campaign to prevent pregnancy-related deaths to birthing hospitals, emergency departments, and obstetricians and other providers who practice obstetrics (§ 6).

EFFECTIVE DATE:

Upon passage, except the provisions (1) requiring birthing hospitals to provide patients with certain educational materials and establish a patient portal and (2) appropriating funds to DPH in FY 23 take effect July 1, 2022.

§ 1 — ALSA TASK FORCE Duties The bill establishes a nine-member task force to study ALSAs that provideservicesasa dementiaspecialcare unitsor programs.The study must examine (1) DPH regulation of these agencies and whether additional department oversight is required, (2) whether minimum staffing levels should be required, and (3) agencies’ maintenance of records on meals served to, bathing of, medication administration to, and overall health of residents.

Membership Under the bill, the task force consists of the following nine members:

1.

two each appointed by the Senate president pro tempore and House speaker;

2.

one each appointed by the Senate and House majority and minority leaders;

and sSB477 / File No.

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535 3.

the DPH commissioner or her designee.

Under the bill, appointing authorities must make their initial appointments within 30 days after the bill’s passage and fill any vacancies.

Appointed members may be legislators.

The bill requires the Senate president pro tempore and House speaker to select the task force chairpersons from among its members.

The chairpersons must schedule the first meeting to be held within 60 days after the bill’s passage.

Under the bill, the Public Health Committee’s administrative staff serve as the task force’s administrative staff.

Report The bill requires the task force, by January 1, 2023, to report its findings and recommendations to the Public Health Committee.

The task force terminates on the date it submits the report or January 1, 2023, whichever is later.

§ 2 — MATERNAL MORTALITY REVIEW COMMITTEE EDUCATIONAL MATERIALS By law, a Maternal Mortality Review Committee within DPH conducts multidisciplinary reviews of maternal deaths to identify associated factors and make recommendations to reduce these deaths.

The bill requires the committee, by January 1, 2023, to develop educational materials on the following topics:

1.

the health and safety of pregnant and postpartum persons with mental health disorders, including perinatal mood and anxiety disorders, for DPH to distribute to each birthing hospital in the state;

2.

evidence-basedscreeningtoolsforscreeningpatientsforintimate partner violence, peripartum mood disorders, and substance use disorder, for DPH to distribute to obstetricians and other health care providers who practice obstetrics;

and sSB477 / File No.

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535 3.

indicators of intimate partner violence for DPH to distribute to (a) hospitals for emergency department health care providers to use and (b) obstetricians and other health care providers who practice obstetrics.

Under thebill, “birthing hospital” means a facility wholly or partially operated to care for patients during child delivery and postpartum persons and their newborns following birth.

§ 3 — BIRTHING HOSPITALS The bill requires birthing hospitals, starting October 1, 2022, to provide each patient who has undergone a caesarean section written information on the importance of mobility and the associated risks of immobility following the procedure.

By January 1, 2023, the bill requires birthing hospitals to establish a patient portal where a postpartum patient can virtually access, through the internet or an application, any educational materials and information that the hospital provided the patient during his or her hospital stay and discharge.

Also starting by this date, the bill requires birth hospitals to provide each postpartum patient the Maternal Mortality Review Committee’s educational materials on the health and safety of pregnant and postpartum persons with mental health disorders, as described above.

§ 5 — COMMISSION ON GUN VIOLENCE INTERVENTION AND PREVENTION Duties The bill establishes a Commission on Gun Violence Intervention and Prevention to do the following:

1.

coordinate the funding and implementation of evidence-based, evidence-informed, community-centric programs and strategies to reduce community gun violence in the state;

2.

secure state, federal, and other funds to reduce community gun sSB477 / File No.

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535 violence;

3.

determine community-level needs by engaging communities impacted by gun violence;

4.

establish and implement a grant program, including awarding grantsandoffering guidance to organizationsworkingonsimilar goals;

5.

obtain any necessary and available assistance from any legislative or executive department, board, or commission;

other state agency;

or any organization or entity to carry out its duties;

6.

accept any gift, donation, or bequest to perform its duties;

7.

establish bylaws to govern its procedures;

and 8.

perform other necessary and appropriate acts to carry out its duties.

Membership Under the bill, the commission consists of the following 21 members:

1.

one representative each from the Connecticut Hospital Association and Compass Youth Collaborative, appointed by the House speaker;

2.

one representative each from the Connecticut Violence Intervention Program and Regional Youth Adult Social Action Partnership, appointed by the Senate president pro tempore;

3.

one representative each from Hartford Communities That Care, Inc.

and CT Against Gun Violence, appointed by the House majority leader;

4.

one representative each from Project Longevity and the Saint Francis Hospital and Medical Center, appointed by the Senate majority leader;

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535 5.

one representative each from Yale New Haven Hospital and the Greater Bridgeport Adolescence Program, appointed by the House minority leader;

6.

one representative of Hartford Hospital and one youth representative of the Connecticut Justice Alliance, appointed by the Senate minority leader;

7.

one representative of the Greater Bridgeport Area Prevention Program and one parent member of the Two Generation Initiative, appointed by the Public Health Committee House chairperson;

8.

one representative each from Mothers United Against Violence and Violent Crime Survivors, appointed by the Public Health Committee Senate chairperson;

9.

one representative of the Health Alliance for Violence Intervention, appointed by the Commission on Women, Children, Seniors, Equity and Opportunity’s (CWCSEO) executive director;

10.

two representatives of DPH’s Injury and Violence Surveillance Unit, appointed by the DPH commissioner;

and 11.

the education commissioner and CWCSEO executive director or their designees.

The bill requires appointing authorities to make initial appointments within 60 days after the bill’s passage.

If an appointment is not made, the commission chairperson may designate a person with the required qualifications to serve on the commission until an appointment is made.

Under the bill, members appointed by the legislative leaders and Public Health Committee chairpersons may be legislators.

Appointed members serve a term that is coterminous with the appointing authority’s and may serve more than one term.

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535 Leadership and Meetings The bill requires the CWCSEO executive director to schedule the commission’s first meeting, which must be held within 60 days after the bill’s passage.

At this meeting, the chairperson must be elected from the commission members.

Under the bill, a majority of commission members constitutes a quorum for transacting business.

Any decision must be made by a majority of members present at the meeting, except that the commission may establish subcommissions, advisory groups, or other entities it deems necessary to further its purposes.

It also requires the commission to adopt procedural rules.

Commission members serve without compensation but may be reimbursed within available funds for necessary expenses in performing their duties.

Executive Director The bill requires the commission, by majority vote, to hire an executive director to serve as its administrative staff and carry out its duties.

It may request assistance from the Joint Commission on Legislative Management in doing so.

Under the bill, the executive director serves at the pleasure of the commission and may hire up to two executive assistants.

The CWCSEO’s administrative staff must serve in that capacity for the commission until the executive director is hired.

Report The bill requires the commission, starting by January 1, 2023, to annually report to the Public Health Committee on its activities during the prior 12 months.

COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 27 Nay 3 (03/30/2022) sSB477 / File No.

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