SB 1012 — AN ACT CONCERNING THE DEPARTMENT OF CHILDREN AND FAMILIES' RECOMMENDATIONS FOR REVISIONS TO STATUTES CONCERNING CHILDREN.

(a) As used in this section:

(1) "Emergency condition" has the same meaning as "emergency medical condition", as provided in section 38a-591a.

(2) "Emergency services" means, with respect to an emergency condition, (A) a medical screening examination as required under Section 1867 of the Social Security Act, as amended from time to time, sSB1012 / File No.

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103 that is within the capability of a hospital emergency department, including ancillary services routinely available to such department to evaluate such condition, and (B) such further medical examinations and treatment required under said Section 1867 to stabilize such individual that are within the capability of the hospital staff and facilities.

(3) "Health care plan" means an individual or a group health insurance policy or health benefit plan that provides coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a- 469.

(4) "Health care provider" means an individual licensed to provide health care services under chapters 370 to 373, inclusive, chapters 375 to 383b, inclusive, and chapters 384a to 384c, inclusive.

(5) "Health carrier" means an insurance company, health care center, hospital service corporation, medical service corporation, fraternal benefit society or other entity that delivers, issues for delivery, renews, amends or continues a health care plan in this state.

(6) (A) "Surprise bill" means a bill for health care services, other than emergency services or urgent crisis center services, received by an insured for services rendered by an out-of-network health care provider, where such services were rendered by (i) such out-of-network provider at an in-network facility, during a service or procedure performed by an in-network provider or during a service or procedure previously approved or authorized by the health carrier andthe insured did not knowingly elect to obtain such services from such out-of- network provider, or (ii) a clinical laboratory, as defined in section 19a- 490, that is an out-of-network provider, upon the referral of an in- network provider.

(B) "Surprise bill" does not include a bill for health care services received by an insured when an in-network health care provider was available to render such services and the insured knowingly elected to obtain such services from another health care provider who was out-of- network.

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103 (7) "Urgent crisis center" means a center [licensed by] operated under the oversight of the Department of Children and Families that is dedicated to treating children's urgent mental or behavioral health needs.

(8) "Urgent crisis center services" means pediatric mental and behavioral health services provided at an urgent crisis center.

Sec.

6.

Section 17a-102a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2023):

(a) Each birthing hospital shall provide education and training for nurses and other staff who care for high-risk newborns on the roles and responsibilities of such nurses and other staff as mandated reporters of potential child abuse and neglect under section 17a-101.

(b) The Department of Children and Families shall coordinate with each birthing hospital in the state to disseminate information regarding (1) procedures for the principal providers of daily direct care of high- risk newborns in birthing hospitals to participate in the discharge planning process, and (2) ongoing department functions concerning high-risk newborns.

(c) Not later than January 1, [2019] 2024, the Commissioner of Children and Families shall, in consultation with other departments, agencies or entities concerned with the health and well-being of children, develop guidelines for the safe care of newborns who exhibit physical, neurological or behavioral symptoms consistent with prenatal substance exposure, withdrawal symptoms from prenatal substance exposure or fetal alcohol spectrum disorder.

Such guidelines shall include, but are not limited to, instructions to providers regarding such providers' participationinthedischarge planning process,including the creation of written [plans of safe care] family care plans, which shall be developed between such providers and [mothers] birth parents of such newborns as part of such process.

(d) A provider involved in the delivery or care of a newborn who, in sSB1012 / File No.

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103 the estimation of such provider, exhibits physical, neurological or behavioral symptoms consistent with prenatal substance exposure, withdrawal symptoms from prenatal substance exposure or fetal alcohol spectrum disorder shall notify the Department of Children and Families of such condition in such newborn.

Such notice shall be made in a form and manner prescribed by the Commissioner of Children and Families and in addition to any applicable reporting requirements pursuant to chapter 319a.

On and after January 15, 2019, such notice shall include a copy of the plan of safe care created pursuant to the guidelines developed pursuant to subsection (c) of this section.

(e) For purposes of this section:

(1) "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 [women] pregnant parents during delivery of a child and for [women] postpartum parents and their newborns following birth;

(2)"High-risknewborn"meansanynewbornidentifiedassuchunder any regulation or policy of the Department of Children and Families;

and (3)"Provider"meansanypersonlicensedpursuanttochapter370,377 or 378.

Sec.

7.

Subdivision (30) of subsection (g) of section 17a-28 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(30) The Department of Public Health for (A) the purpose of notification when the Commissioner of Children and Families places an individual licensed or certified by the Department of Public Health on the child abuse and neglect registry established pursuant to section 17a- 101k, and (B) purposes relating to the licensure of the Albert J.

Solnit Children's Center and the administration of licensing requirements established pursuant to or set forth in sections 19a-134 and 19a-498;

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103 Sec.

8.

Section 1 July 1, 2023 17a-114 LCOSec. No.

4017 6 of 7 Raised Bill No.

1012 Sec.

3 July 1, 2023 Repealer17a-126(i) sectionSec. Statement of Purpose:

To4 (1)exemptJuly certainapplicantsfor1, foster2023 care19a-179f(b) licensureSec. andindividuals eighteen years of age or older living in such applicants' homes from submitting to criminal history records checks requirements under certain circumstances, and (2) increase the age upon which an individual living in the home of an applicant for foster care licensure must submit to criminal history records checks and child abuse registry checks from sixteen to eighteen.

[Proposed5 deletionsJuly are1, enclosed2023 in38a-477aa(a) brackets.Sec.

Proposed6 additionsJuly are1, indicated2023 by17a-102a underline,Sec. except underlined.]e entire text of a bill or resolution or a section of a bill or resolution is new, it is not LCO No.

4017 7 offrom 7passage 17a-28(g)(30) Sec.

8 July 1, 2023 Repealer section Statement of Legislative Commissioners:

In Section 1(c)(1)(A), "each person residing in the home" was changed to "each person eighteen years of age or older residing in the home" for consistency, inSection 1(c)(2),"performstate andnational"was changed to "perform a state and national" for clarity, in Section 1(c)(3), "denies emergency placement" was changed to "denies an emergency placement" for clarity, and in Section 6(e)(1), "pregnant parents" was changed to "postpartum parents" for accuracy.

KID Joint Favorable Subst.

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103 The following Fiscal Impact Statement and Bill 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.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 24 $ FY 25 $ Children & Families, Dept.

GF - Savings 20,704 20,704 Note:

GF=General Fund Municipal Impact:

None Explanation The bill, which exempts individuals under eighteen years of age that live in a Department of Children and Families (DCF) foster care applicant's home from submitting to state and national background checks and child abuse registry checks, is anticipated to result in a savings to the agency of approximately $20,704 annually.

The Department's current foster home licensure regulations require state and national background checks and child abuse registry checks for all adults and all adolescents 16 years of age and older, prior to issuance of a placement license.

While child abuse registry checks are performed in-house by the agency, state and national background checks are performed by the Connecticut State Police at a cost to DCF of $32.00 per check.

DCF does not track the ages of the individuals for whom background check inquiries have been submitted.

It is estimated that approximately 50% of the homes for which licensure inquiries are submitted include at least one adolescent between the ages of 16 and 17.

Based on this assumption, with 1,294 licensing requests submitted in FY 22, approximately 647 included at least one 16- or 17-year-old.

Not performing state and national background checks for these individuals results in a savings to DCF of approximately $20,704 in each fiscal year.

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103 Other provisions of the bill are not anticipated to result in a fiscal impact to the State or municipalities.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to the number of 16- and 17-years-olds that live in a DCF foster care applicant's home.

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103 OLR Bill Analysis sSB 1012 AN ACT CONCERNING THE DEPARTMENT OF CHILDREN AND FAMILIES' RECOMMENDATIONS FOR REVISIONS TO STATUTES CONCERNING CHILDREN.

SUMMARY This bill makes several changes in laws related to the Department of Children and Families (DCF).

The billlimitswhen DCF may do certainbackgroundchecks on foster care provider applicants by (1) increasing, from 16 to 18, the minimum age at which household members must submit to these checks and (2) generally prohibiting them if they have been done in the last 12 months (§ 1).

It also reorganizes and combines current laws on emergency placements and placements with a relative or fictive kin (i.e., a person who has a family-like relationship with the child);

and in doing so, eliminates the duplicative background checks required for licensure for these placements under current law (§§ 1 & 8).

Among other things, the bill also:

1.

specifically allows the mandatory home visits to investigate a report of child abuse or neglect to be done by video or other conferencing platform during certain state or national emergencies (e.g., a pandemic) (§ 2);

2.

allows subsidies (e.g., special-need subsidy) received by an adoptive parent who dies or becomes disabled or ill to transfer to a successor guardian in certain circumstances (§ 3);

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103 3.

requires urgent crisis centers that are dedicated to treating children’s urgent mental or behavioral health needs to operate under DCF oversight rather than under a DCF issued license as required under current law (§§ 4 & 5);

4.

requires DCF, by January 1, 2024, to update its existing guidelines for the safe care of substance-exposed newborns (§ 6);

and 5.

requires DCF to disclose records, without the subject’s consent, to the Department of Public Health (DPH) for purposes relating to licensure of the Albert J.

Solnit Children’s Center (“Solnit Children’s Center”) (§ 7).

It also makes changes to conform to the Connecticut Parentage Act (PA 21-15) which, among other things, removed certain gender specific references (e.g., “mother” to “birth parent”).

Lastly, the bill makes technical changes, including eliminating obsolete language on regular unsupervised access (§ 1).

EFFECTIVE DATE:

July 1, 2023, except the provision giving DPH access to DCF records regarding licensure of Solnit Children’s Center is effective upon passage.

§§ 1 & 8 — BACKGROUND CHECKS Foster Care License, Adoption Approval, or Renewal (§ 1) Under current law, before issuing a license to someone who applied to become a foster care provider or an approval to adopt a child (“applicant”), DCF must first require state and national criminal history and state child abuse registry records checks on the applicant and anyone living in the applicant’s household who is age 16 or older.

The care provider and anyone age 16 or older living in the household must again submit to these same background checks at the time of license or approval renewal.

The bill increases, from 16 to 18, the minimum age at which an applicant’s household member must submit to background checks.

sSB1012 / File No.

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103 The bill also prohibits the commissioner from requiring an applicant or anyone age 18 or older living in the applicant’s household to submit to the state and national criminal history records checks if the person has submitted to these background checks within the previous 12- month period in connection with an emergency placement (see below).

Emergency Placement (§§ 1 & 8) Under certain circumstances, current law allows the commissioner to place a child with a relative or fictive kin caregiver who has not been issued a license or approval, if, among other things, it is in the child’s best interests.

Instead of “relative or fictive kin,” the bill refers to this typeofplacementasan“emergencyplacement,”andmakesconforming changes to the laws that address required licensure and approval of a person who accepts placement on an emergency basis.

It repeals the current statute that governs emergency placements and simultaneously combinesit withthatonplacementwitharelativeorfictivekin.Indoing so, the bill eliminates the duplicative background checks required for licensure under current law for these placements.

Current law authorizes the commissioner to make a placement with such a relative or fictive kin caregiver if:

1.

a satisfactory home visit is conducted and a basic assessment of the family is completed;

and 2.

therelative or fictive kincaregiverattests thatthey, andany adult living in the household, have not been convicted of a crime or arrested for a felony against a person;

injury or risk of injury to or impairing the morals of a child;

or possession, use, or sale of a controlled substance.

The bill no longer requires the caregiver to make an attestation about any convictions or arrests for these crimes.

Instead, the bill requires the commissioner to do what current law allows for emergency placements, which is to request a criminal justice agency to do a federal name-based criminal history search.

Under current law, the commissioner may do so for each person residing in the home.

The bill requires her to do so sSB1012 / File No.

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103 only for each person aged 18 or older residing in the home and to also do a state child abuse and neglect registry check for these individuals.

The other emergency placement provisions under existing law generally remain unchanged under the bill, such as those related to the:

1.

required state and national criminal history records checks that must occur after the name-based search has been completed (the billincreases, fromfive to 15days,thedeadlinefor DCF to request the state police to perform the check after the search);

2.

commissioner’s mandate to remove the child from the home of anyone who refuses to provide fingerprints or other positive identification;

and 3.

person’s right to request a state or national criminal history check if denied emergency placement based on a name-based search.

Under existing law, unchanged by the bill, an “emergency placement” is the placement of a child by DCF in someone’s home, including a child’s neighbor, friend, or relative, because of the sudden unavailability of the child’s primary caretaker.

§ 2 — HOME VISITS IN A PANDEMIC By law, all investigations of any report of abuse or neglect of a child must include a home visit by DCF.

The bill specifically allows these home visits to be done by video or other conferencing platform (i.e., online), instead of in-person, in the event of a pandemic or communicable disease outbreak resulting in a declaration of a public health emergency by the Governor or a national emergency by the President.

Under the bill, these home visits can be done online for as long as the declaration lasts.

§ 3 — SUBSIDIZED GUARDIANSHIP PROGRAM Under existing law, if a caregiver who is receiving guardianship subsidies dies or becomes severely disabled or seriously ill, the DCF commissioner may transfer the subsidies to a successor guardian who sSB1012 / File No.

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103 meets the department’s foster care safety requirements and who is appointedaslegalguardianby acourt.

The billallowsthecommissioner to also do this in a case involving an adoptive parent under similar circumstances who was receiving a subsidy.

As is the case for a caregiver under existing law, the bill requires the adoptive parent to identify the successor guardian in the subsidy agreement and any addendum to it.

By law, if DCF certifies a child as special needs before adoption, it must provide certain subsidies for the adopting parents.

This may include a special-need subsidy (i.e., a lump sum payment to the service provider), a periodic subsidy to the adopting family for the cost of care, or both.

In addition, Medicaid benefits that were provided before the adoption must continue if the child qualifies as the adoptive parent’s dependent for federal tax purposes (CGS § 17a-117).

§§ 4 & 5 — URGENT CRISIS CENTERS Under current law, an “urgent crisis center” is a DCF-licensed center dedicated to treating children’s urgent mental or behavioral health needs and “urgent crisis center services” are pediatric mental and behavioral health services provided at one of these centers.

Under the bill,these centersmust operateunderDCF’soversightratherthanunder the department’s direct licensure, as required by current law.

In doing so, the bill allows these centers to be licensed by an agency other than DCF (presumably, DPH), but they must operate under DCF’s oversight.

This applies to existing laws that govern (1) protocols DPH’s Office of Emergency Medical Services must develop by January 1, 2024, for certain emergency medical services providers to transport childrenwith mental or behavioral health needs by ambulance to urgent crisis centers and (2) health insurance coverage for, and emergency access to, urgent crisis center services (e.g., prohibition on balance billing, higher out-of- network billing, and pre-authorization).

§ 6 — SAFE CARE OR SUBSTANCE-EXPOSED NEWBORNS The law required, by January 1, 2019, the DCF commissioner, in sSB1012 / File No.

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103 consultation with other departments, agencies, or entities concerned with the health and wellbeing of children, to develop guidelines for the safe care of newborns who exhibit (1) physical, neurological, or behavioral symptoms consistent with prenatal substance exposure;

(2) associated withdrawal symptoms;

or (3) fetal alcohol syndrome.

As under existing law, the guidelines must include instructions to providers on the discharge planning process, including written plans of safe care.

The bill (1) replaces the term “plans of safe care” with “family care plan” and (2) requires the commissioner to update these guidelines by January 1, 2024.

It also conforms to the Connecticut Parentage Act (PA 21-15) by removing certain gender-specific references (e.g., “mother” to “birth parent” and “women” to “pregnant parents”).

§ 7 — DPH ACCESS TO DCF INFORMATION FOR SOLNIT CHILDREN’S CENTER LICENSURE By law, records maintained by DCF are generally confidential and must not be disclosed without the subject’s consent, subject to various exceptions.

Existing law requires DCF to disclose records, without consent, to inform DPH that the DCF commissioner placed a DPH- licensed or -certified person onthechildabuse andneglect registry.

This bill requires DCF to also disclose information to DPH without consent for purposes relating to the licensure of Solnit Children’s Center.

(Solnit is operated by DCF and licensed by DPH.) COMMITTEE ACTION Committee on Children Joint Favorable Substitute Yea 17 Nay 2 (02/28/2023) sSB1012 / File No.

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