SB 1070 — AN ACT CONCERNING PHYSICIAN ASSISTANTS.

1070 the health of others, the public health official shall notify the chief administrative officer of such institution.

Such chief administrative officer shall cause the student to be excluded from the institution, or confined in an infirmary or other medical facility at the institution, until the student presents to such chief administrative officer a certificate from a physician, a physician assistant or an advanced practice registered nurse stating that, in the opinion of such physician, physician assistant or advanced practice registered nurse, the presence in the institution of the student does not present a clear danger to the health of others.

Sec.

7.

Section 12-94 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

The exemptions granted in sections 12-81 and 12-82 to soldiers, sailors, marines and members of the Coast Guard and Air Force, and their spouses, widows, widowers, fathers and mothers, and to blind or totallydisabledpersonsandtheirspousesshallfirstbemadeinthetown in which the person entitled thereto resides, and any person asking such exemption in any other town shall annually make oath before, or forward his or her affidavit to, the assessors of such town, deposing that such exemptions, except the exemption provided in subdivision (55) of section 12-81, if allowed, will not, together with any other exemptions granted under sections 12-81 and 12-82, exceed the amount of exemption thereby allowed to such person.

Such affidavit shall be filed with the assessors within the periodthe assessors have to complete their dutiesinthetownwheretheexemptionisclaimed.Theassessorsofeach town shall annually make a certified list of all persons who are found to beentitledto exemptionunder theprovisions ofsaid sections, which list shall be filed in the town clerk's office, and shall be prima facie evidence that the persons whose names appear thereon and who are not required by law to give annual proof are entitled to such exemption as long as they continue to reside in such town;

but such assessors may, at any Public Act No.

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1070 time, require any such person to appear before them for the purpose of furnishing additional evidence, provided, any person who by reason of such person's disability is unable to so appear may furnish such assessors a statement from such person's attending physician, physician assistant or an advanced practice registered nurse certifying that such person is totally disabled and is unable to make a personal appearance and such other evidence of total disability as such assessors may deem appropriate.

Sec.

8.

Subsection (a) of section 12-129c of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) No claim shall be accepted under section 12-129b unless the taxpayer or authorized agent of such taxpayer files an application with the assessor of the municipality in which the property is located, in affidavit form as provided by the Secretary of the Office of Policy and Management, during the period from February first to and including May fifteenth of any year in which benefits are first claimed, including suchinformationasisnecessary to substantiate saidclaiminaccordance with requirements in such application.

A taxpayer may make application to the secretary prior to August fifteenth of the claim year for an extension of the application period.

The secretary may grant such extension in the case of extenuating circumstance due to illness or incapacitation as evidenced by a certificate signed by a physician, a physician assistant or an advanced practice registered nurse to that extent, or if the secretary determines there is good cause for doing so.

The taxpayer shall present to the assessor a copy of such taxpayer's federal income tax return and the federal income tax return of such taxpayer's spouse, if filed separately, for such taxpayer's taxable year ending immediately prior to the submission of the taxpayer's application, or if not required to file a federal income tax return, such other evidence of qualifying income in respect to such taxable year as Public Act No.

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1070 the assessor may require.

Each such application, together with the federal income tax return and any other information submitted in relation thereto, shall be examined by the assessor and if the application is approved by the assessor, it shall be forwarded to the secretary on or before July first of the year in which such application is approved, except that in the case of a taxpayer who received a filing date extension from the secretary, such application shall be forwarded to the secretary not later thantenbusinessdaysafter thedate it isfiled withtheassessor.

After a taxpayer's claim for the first year has been filed and approved such taxpayer shall be required to file such an application biennially.

In respect to such application required after the filing and approval for the first year the tax assessor in each municipality shall notify each such taxpayer concerning application requirements by regular mail not later than February first of the assessment year in which such taxpayer is required to reapply, enclosing a copy of the required application form.

Such taxpayer may submit such application to the assessor by mail, provided it is received by the assessor not later than April fifteenth in the assessment year with respect to which such tax relief is claimed.

Not later than April thirtieth of such year the assessor shall notify, by mail evidenced by a certificate of mailing, any such taxpayer for whom such application was not received by said April fifteenth concerning application requirements and such taxpayer shall be required not later than May fifteenth to submit such application personally or for reasonable cause, by a person acting on behalf of such taxpayer as approved by the assessor.

Sec.

9.

Subsection (f) of section 12-170aa of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(f) Any homeowner, believing such homeowner is entitled to tax reduction benefits under this section for any assessment year, shall make application as required in subsection (e) of this section, to the Public Act No.

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1070 assessor of the municipality in which the homeowner resides, for such tax reduction at any time from February first to and including May fifteenth of the year in which tax reduction is claimed.

A homeowner may make application to the secretary prior to August fifteenth of the claim year for an extension of the application period.

The secretary may grant such extension in the case of extenuating circumstance due to illness or incapacitation as evidenced by a certificate signed by a physician, physician assistant or an advanced practice registered nurse tothatextent,orifthesecretarydeterminesthereisgoodcausefordoing so.

Such application for tax reduction benefits shall be submitted on a form prescribed and furnished by the secretary to the assessor.

In making application the homeowner shall present to such assessor, in substantiation of such homeowner's application, a copy of such homeowner's federal income tax return, including a copy of the Social Security statement of earnings for such homeowner, and that of such homeowner's spouse, if filed separately, for such homeowner's taxable year ending immediately prior to the submission of such application, or if not required to file a return, such other evidence of qualifying income in respect to such taxable year as may be required by the assessor.

When the assessor is satisfied that the applying homeowner is entitled to tax reduction in accordance with this section, such assessor shall issue a certificate of credit, in such form as the secretary may prescribe and supply showing the amount of tax reduction allowed.

A duplicate of such certificate shall be delivered to the applicant and the tax collector of the municipality and the assessor shall keep the fourth copy of such certificate and a copy of the application.

Any homeowner who, for the purpose of obtaining a tax reduction under this section, wilfully fails to disclose all matters related thereto or with intent to defraud makes false statement shall refund all property tax credits improperly taken and shall be fined not more than five hundred dollars.

Applications filed under this section shall not be open for public inspection.

Sec.

10.

Subsection (a) of section 12-170f of the general statutes is Public Act No.

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1070 repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) Any renter, believing himself or herself to be entitled to a grant under section 12-170d for any calendar year, shall apply for such grant to the assessor of the municipality in which the renter resides or to the duly authorized agent of such assessor or municipality on or after April first and not later than October first of each year with respect to such grant for the calendar year preceding each such year, on a form prescribed and furnished by the Secretary of the Office of Policy and Management to the assessor.

A renter may apply to the secretary prior to December fifteenth of the claim year for an extension of the application period.

The secretary may grant such extension in the case of extenuating circumstance due to illness or incapacitation as evidenced by a certificate signed by a physician, physician assistant or an advanced practice registered nurse to that extent, or if the secretary determines there is good cause for doing so.

A renter making such application shall present to such assessor or agent, in substantiation of the renter's application, a copy of the renter's federal income tax return, and if not required to file a federal income tax return, such other evidence ofqualifying income, receipts for money received,or cancelled checks, or copies thereof, and any other evidence the assessor or such agent may require.

When the assessor or agent is satisfied that the applying renter is entitled to a grant, such assessor or agent shall issue a certificate of grant in such form as the secretary may prescribe and supply showing the amount of the grant due.

Sec.

11.

Subsection (a) of section 12-170w of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) No claim shall be accepted under section 12-170v unless the taxpayer or authorized agent of such taxpayer files an application with the assessor of the municipality in which the property is located, in such Public Act No.

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1070 form and manner as the assessor may prescribe, during the period from February first to and including May fifteenth of any year in which benefits are first claimed, including such information as is necessary to substantiate such claim in accordance with requirements in such application.

A taxpayer may make application to the assessor prior to August fifteenth of the claim year for an extension of the application period.The assessor may grant suchextensioninthe case ofextenuating circumstance due to illness or incapacitation as evidenced by a certificate signed by a physician, a physician assistant or an advanced practice registered nurse to that extent, or if the assessor determines there is good cause for doing so.

The taxpayer shall present to the assessor a copy of such taxpayer's federal income tax return and the federal income tax return of such taxpayer's spouse, if filed separately, for such taxpayer's taxable year ending immediately prior to the submission of the taxpayer's application, or if not required to file a federal income tax return, such other evidence of qualifying income in respect to such taxable year as the assessor may require.

Each such application, together with the federal income tax return and any other information submitted in relation thereto, shall be examined by the assessor and a determination shall be made as to whether the application is approved.

Upon determination by the assessor that the applying homeowner is entitled to tax relief in accordance with the provisions of section 12-170v and this section, the assessor shall notify the homeowner and the municipal tax collector of the approval of such application.

The municipal tax collector shall determine the maximum amount of the tax due with respect to such homeowner's residence and thereafter the property tax with respect to such homeowner's residence shall not exceed such amount.

After a taxpayer's claim for the first year has been filed and approved such taxpayer shall file such an application biennially.

In respect to such application required after the filing and approval for the first year the assessor in each municipality shall notify eachsuchtaxpayerconcerningapplicationrequirementsbyregularmail not later than February first of the assessment year in which such Public Act No.

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1070 taxpayer is required to reapply, enclosing a copy of the required application form.

Such taxpayer may submit such application to the assessor by mail, provided it is received by the assessor not later than April fifteenth in the assessment year with respect to which such tax relief is claimed.

Not later than April thirtieth of such year the assessor shall notify, by mail evidenced by a certificate of mailing, any such taxpayer for whom such application was not received by said April fifteenth concerning application requirements and such taxpayer shall submit not later than May fifteenth such application personally or for reasonable cause, by a person acting on behalf of such taxpayer as approved by the assessor.

Sec.

12.

Subsection (b) of section 14-73 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(b) Application for an instructor's license shall be in writing and shall contain such information as the commissioner requires.

Each applicant for a license shall be fingerprinted and shall furnish evidence satisfactory to the commissioner that such applicant (1) is of good moral character considering such person's state and national criminal history recordschecksconducted inaccordance withsection29-17a,andrecord, if any, on the state child abuse and neglect registry established pursuant to section 17a-101k.

If any applicant for a license or the renewal of a license has a criminal record or is listed on the state child abuse and neglect registry, the commissioner shall make a determination of whether to issue or renew an instructor's license in accordance with the standards and procedures set forth in section 14-44 and the regulations adopted pursuant to said section;

(2) has held a license to drive a motor vehicle for the past four consecutive years and has a driving record satisfactory to the commissioner, including no record of a conviction or administrative license suspension for a drug or alcohol-related offense during such four-year period;

(3) has had a recent medical examination Public Act No.

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1070 by a physician, physician assistant or an advanced practice registered nurse licensed to practice within the state and the physician, physician assistant or advanced practice registered nurse certifies that the applicant is physically fit to operate a motor vehicle and instruct in driving;

(4) has received a high school diploma or has an equivalent academic education;

and (5) has completed an instructor training course of forty-five clock hours given by a school or agency approved by the commissioner, exceptthat any suchcoursegivenby aninstitutionunder the jurisdiction of the board of trustees of the Connecticut State University System shall be approved by the commissioner and the State Board of Education.

During the period of licensure, an instructor shall notify the commissioner, within forty-eight hours, of an arrest or conviction for a misdemeanor or felony, or an arrest, conviction or administrative license suspension for a drug or alcohol-related offense.

Sec.

13.

Subdivision (2) of subsection (c) of section 14-100a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(2) The provisions of subdivision (1) of this subsection shall not apply to (A) any person whose physical disability or impairment would prevent restraint in such safety belt, provided such person obtains a written statement from a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse containing reasonsforsuchperson'sinabilitytowearsuchsafetybeltandincluding information concerning the nature and extent of such condition.

Such person shall carry the statement on his or her person or in the motor vehicle at all times when it is being operated, or (B) an authorized emergency vehicle, other than fire fighting apparatus, responding to an emergency call or a motor vehicle operated by a rural letter carrier of the United States postal service while performing his or her official duties or by a person engaged in the delivery of newspapers.

Sec.

14.

Subsection (c) of section 14-286 of the general statutes is Public Act No.

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1070 repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(c) (1) The Commissioner of Motor Vehicles may issue to a person who does not hold a valid operator's license a special permit that authorizes such person to ride a motor-driven cycle if (A) such person presents to the commissioner a certificate by a physician licensed to practice medicine in this state, a physician assistant licensed pursuant to chapter 370 or an advanced practice registered nurse licensed pursuant to chapter 378 that such person is physically disabled, as defined in section 1-1f, other than blind, and that, in the physician's, physician assistant's or advanced practice registered nurse's opinion, such person is capable of riding a motor-driven cycle, and (B) such person demonstrates to the Commissioner of Motor Vehicles that he is able to ride a bicycle on level terrain, and a motor-driven cycle.

(2) Such permit may contain limitations that the commissioner deems advisable for the safety of such person and for the public safety, including, but not limited to, the maximum speed of the motor such person may use.

No person who holds a valid special permit under this subsection shall operate a motor-driven cycle in violation of any limitations imposed in the permit.

Any person to whom a special permit is issued shall carry the permit at all times while operating the motor-driven cycle.

Each permit issued under this subsection shall expire one year from the date of issuance.

Sec.

15.

Subsection (a) of section 14-314c of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) The Office of the State Traffic Administration, on any state highway, or a local traffic authority, on any highway under its control, shall, upon receipt of an application on behalf of any person under the age of eighteen who is deaf, as certified by a physician, a physician assistant or an advanced practice registered nurse, erect one or more Public Act No.

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1070 signs in the person's neighborhood to warn motor vehicle operators of the presence of such person.

Sec.

16.

Subdivision (1) of subsection (b) of section 16-262c of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(b) (1) From November first to May first, inclusive, no electric distributioncompany,asdefinedinsection16-1,noelectricsupplierand no municipalutility furnishing electricity shallterminate,denyorrefuse to reinstate residential electric service in hardship cases where the customer lacks the financial resources to pay his or her entire account.

From November first to May first, inclusive, no gas company and no municipal utility furnishing gas shall terminate, deny or refuse to reinstate residential gas service in hardship cases where the customer uses such gas for heat and lacks the financial resources to pay his or her entire account, except a gas company that, between May second and October thirty-first, terminated gas service to a residential customer who uses gas for heat and who, during the previous period of November first to May first, had gas service maintained because of hardship status, may refuse to reinstate the gas service from November first to May first, inclusive, only if the customer has failed to pay, since the preceding November first, the lesser of:

(A) Twenty per cent of the outstanding principal balance owed the gas company as of the date of termination, (B) one hundred dollars, or (C) the minimum payments due under the customer's amortization agreement.

Notwithstanding any other provision of the general statutes to the contrary, no electric distribution or gas company, no electric supplier and no municipal utility furnishing electricity or gas shall terminate, deny or refuse to reinstate residential electric or gas service where the customer lacks the financial resources to pay his or her entire account and for which customer or a member of the customer's household the termination, denial of or failure to reinstate such service would create a life- Public Act No.

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1070 threatening situation.

No electric distribution or gas company, no electric supplier and no municipal utility furnishing electricity or gas shall terminate, deny or refuse to reinstate residential electric or gas service where the customer is a hardship case and lacks the financial resources to pay his or her entire account and a child not more than twenty-four months old resides in the customer's household and such child has been admitted to the hospital and received discharge papers on which the attending physician, physician assistant or an advanced practice registered nurse has indicated such service is a necessity for the health and well-being of such child.

Sec.

17.

Subsection (b) of section 16-262d of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(b) No such company, electric supplier or municipal utility shall effect termination of service for nonpayment during such time as any resident of a dwelling to which such service is furnished is seriously ill, if the fact of such serious illness is certified to such company, electric supplier or municipal utility by a registered physician, a physician assistant or an advanced practice registered nurse within such period of time after the mailing of a termination notice pursuant to subsection (a) of this section as the Public Utilities Regulatory Authority may by regulation establish, provided the customer agrees to amortize the unpaid balance of his account over a reasonable period of time and keeps current his account for utility service as charges accrue in each subsequent billing period.

Sec.

18.

Subsection (a) of section 17a-81 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) Parental consent shall be necessary for treatment.

In the event such consent is withheld or immediately unavailable and the physician, Public Act No.

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1070 physician assistant or advanced practice registered nurse certified as a psychiatric mental health provider by the American Nurses Credentialing Center concludes that treatment is necessary to prevent serious harm to the child, such emergency treatment may be administered pending receipt of parental consent.

Sec.

19.

Section 17b-233 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

Newington Children's Hospital may admit any child who is handicapped or afflicted with any pediatric illness upon application of the selectmen of any town, or the guardian or any relative of such child, or any public health agency, physician, physician assistant or advanced practice registered nurse, provided, no person shall be admitted primarily for the treatment of any drug-related condition.

Said hospital shall admit such child to said hospital if such child is pronounced by a physician,aphysicianassistantoranadvancedpracticeregisterednurse on the staff of said hospital, after examination, to be suitable for admission, and said hospital shall keep and support such child for such length of time as it deems proper.

Said hospital shall not be required to admit any suchchildunlessit canconveniently receive andcare for such child at the time application is made and said hospital may return to the town in which such child resides any child so taken who is pronounced by a physician, a physician assistant or an advanced practice registered nurse on the staff of said hospital, after examination, to be unsuitable for retention or who, by reason of improvement in his condition or completion of his treatment or training, ought not to be further retained.

The hospital may refuse to admit any child pronounced by a physician, a physician assistant or an advanced practice registered nurse on the staff of said hospital, after examination, to be unsuitable for admission andmayrefusetoadmitanysuchchildwhenthefacilitiesatthehospital will not, in the judgment of [said] such physician, physician assistant or advanced practice registered nurse, permit the hospital to care for such Public Act No.

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1070 child adequately and properly.

Sec.

20.

Section 17b-236 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

Whenthere isfoundinany towninthisstate any childofsoundmind who is physically disabled or who is afflicted with poliomyelitis or rheumatic fever, or any uncontagious disabling disease, and who is unable to pay and whose relatives who are legally liable for his support are unable to pay the full cost of treating such disease, if such child and one of such relatives reside in this state, the selectmen of such town, or the guardian or any relative of such child, or any public health agency, physician, physician assistant or advanced practice registered nurse in this state, may make application to The Children's Center, located at Hamden, for the admission of such child to said center.

Said center shall admit such child if such child is pronounced by a physician, a physician assistant or an advanced practice registered nurse on the staff of said center, after examination, to be fit for admission, and said center shall keep and support such child for such length of time as it deems proper.

Said center shall not be required to admit any such child unless it can conveniently receive and care for him at the time such application is made, and said center may return to the town in which such child resides any child so taken who is pronounced by a physician, a physician assistant or an advanced practice registered nurse on the staff of said center, after examination, to be unfit for retention, or who, by reason of improvement in his condition or completion of his treatment or training, ought not to be further retained.

The center may refuse to admit any child who is pronounced by a physician, a physician assistant or an advanced practice registered nurse on the staff of said center, after examination, to be unfit for admission, and may refuse to admit any such child when the facilities at the center will not, in the judgment of [said] such physician, physician assistant or advanced practice registered nurse, permit the center to care for such child adequately and Public Act No.

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1070 properly.

Sec.

21.

Subsection (f) of section 17b-261p of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(f) (1) A nursing home, on behalf of an applicant, may request an extension of time to claim undue hardship pursuant to subsections (b) and (e) of this section if (A) the applicant is receiving long-term care services in such nursing home, (B) the applicant has no legal representative, and (C) the nursing home provides certification from a physician,aphysicianassistantoranadvancedpracticeregisterednurse that the applicant is incapable of caring for himself or herself, as defined insection45a-644, or incapableofmanaging hisor her affairs,asdefined in section 45a-644.

The commissioner shall grant such request to allow a legal representative to be appointed to act on behalf of the applicant.

(2) The commissioner shall accept any claim filed pursuant to subsection (b) of this section by a nursing home and allow the nursing home to represent the applicant with regard to such claim if the applicant or the legal representative of the applicant gives permission to the nursing home to file a claim pursuant to subsection (b) of this section.

Sec.

22.

Section 17b-278d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

The Commissioner of Social Services, to the extent permitted by federal law, shall take such action as may be necessary to amend the Medicaid state plan and the state children's health insurance plan to provide coverage without prior authorization for each child diagnosed with cancer on or after January 1, 2000, who is covered under the HUSKY Health program, for neuropsychological testing ordered by a licensed physician, licensed physician assistant or licensed advanced Public Act No.

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1070 practice registered nurse, to assess the extent of any cognitive or developmental delays in such child due to chemotherapy or radiation treatment.

Sec.

23.

Section 18-94 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

When the medical officer of, or any physician, physician assistant or advanced practice registered nurse employed in, any correctional or charitable institution reports in writing to the warden, superintendent or other officer in charge of such institution that any inmate thereof committed thereto by any court or supported therein in whole or in part at public expense is afflicted with any sexually transmitted disease so that such inmate's discharge from such institution would be dangerous to the public health, such inmate shall, with the approval of such warden, superintendent or other officer in charge, be detained in such institution until such medical officer, physician, physician assistant or advanced practice registered nurse reports in writing to the warden, superintendent or officer in charge of such institution that such inmate may be discharged therefrom without danger to the public health.

During detention the person so detained shall be supported in the same manner as before such detention.

Sec.

24.

Section 19a-2a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

The Commissioner of Public Health shall employ the most efficient and practical means for the prevention and suppression of disease and shall administer all laws under the jurisdiction of the Department of Public Health and the Public Health Code.

The commissioner shall have responsibility for the overall operation and administration of the Department of Public Health.

The commissioner shall have the power and duty to:

(1) Administer, coordinate and direct the operation of the department;

(2) adopt and enforce regulations, in accordance with Public Act No.

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1070 chapter 54, as are necessary to carry out the purposes of the department as established by statute;

(3) establish rules for the internal operation and administration of the department;

(4) establish and develop programs and administer services to achieve the purposes of the department as established by statute;

(5) enter into a contract, including, but not limited to, a contract with another state, for facilities, services and programs to implement the purposes of the department as established by statute;

(6) designate a deputy commissioner or other employee of the department to sign any license, certificate or permit issued by said department;

(7) conduct a hearing, issue subpoenas, administer oaths, compel testimony and render a final decision in any case when a hearing is required or authorized under the provisions of any statute dealing with the Department of Public Health;

(8) with the health authorities of this and other states, secure information and data concerning the prevention and control of epidemics and conditions affecting or endangering the public health, and compile such information and statistics and shall disseminate among health authorities and the people of the state such information as may be of value to them;

(9) annually issue a list of reportable diseases, emergency illnesses and health conditions and a list of reportable laboratory findingsandamendsuchlistsasthecommissionerdeemsnecessary and distribute such lists as well as any necessary forms to each licensed physician, licensed physician assistant, licensed advanced practice registered nurse and clinical laboratory in this state.

The commissioner shall prepare printed forms for reports and returns, with such instructions as may be necessary, for the use of directors of health, boards of health and registrars of vital statistics;

and (10) specify uniform methods of keeping statistical information by public and private agencies, organizations and individuals, including a client identifier system, and collect and make available relevant statistical information, including the number of persons treated, frequency of admission and readmission, and frequency and duration of treatment.

The client identifier system shall be subject to the confidentiality Public Act No.

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1070 requirements set forth in section 17a-688 and regulations adopted thereunder.

The commissioner may designate any person to perform any of the duties listed in subdivision (7) of this section.

The commissioner shall have authority over directors of health and may, for cause, remove any such director;

but any person claiming to be aggrieved by such removal may appeal to the Superior Court which may affirm or reverse the action of the commissioner as the public interest requires.

The commissioner shall assist and advise local directors of health and district directors of health in the performance of their duties, and may require the enforcement of any law, regulation or ordinance relating to public health.

In the event the commissioner reasonably suspects impropriety on the part of a local director of health or district director of health, or employee of such director, in the performance of his or her duties, the commissioner shall provide notification and any evidence of such impropriety to the appropriate governing authority of the municipal health authority, established pursuant to section 19a-200, or the district department of health, established pursuant to section 19a-244, for purposes of reviewing and assessing a director's or an employee's compliance with such duties.

Such governing authority shall provide a written report of its findings from the review and assessment to the commissioner not later than ninety days after such review and assessment.

When requested by local directors of health or district directors of health, the commissioner shall consult with them and investigate and advise concerning any condition affecting public health within their jurisdiction.

The commissioner shall investigate nuisances and conditions affecting, or that he or she has reason to suspect may affect, the security of life and health in any locality and, for that purpose, the commissioner, or any person authorized by the commissioner, may enter and examine any ground, vehicle, apartment, building or place, and any person designated by the commissioner shall have the authority conferred by law upon constables.

Whenever the commissioner determines that any provision of the general statutes or regulation of the Public Health Code is not Public Act No.

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1070 beingenforcedeffectivelybyalocalhealthdepartmentorhealthdistrict, he or she shall forthwith take such measures, including the performance of any act required of the local health department or health district, to ensure enforcement of such statute or regulation and shall inform the local health department or health district of such measures.

In September of each year the commissioner shall certify to the Secretary of the Office of Policy and Management the population of each municipality.

The commissioner may solicit and accept for use any gift of money or property made by will or otherwise, and any grant of or contract for money, services or property from the federal government, the state, any political subdivision thereof, any other state or any private source, and do all things necessary to cooperate with the federal governmentoranyofitsagenciesinmakinganapplicationforanygrant or contract.

The commissioner may establish state-wide and regional advisory councils.

For purposes of this section, "employee of such director" means an employee of, a consultant employed or retained by or an independent contractor retained by a local director of health, a district director of health, a local health department or a health district.

Sec.

25.

Subsection (a) of section 19a-26 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) The Department of Public Health may establish, maintain and control state laboratories to perform examinations of supposed morbid tissues, other laboratory tests for the diagnosis and control of preventable diseases, and laboratory work in the field of sanitation, environmental and occupational testing and research studies for the protection and preservation of the public health.

Such laboratory services shall be performed upon the application of licensed physicians, other laboratories, licensed dentists, licensed podiatrists, licensed physician assistants, licensed advanced practice registered nurses, local directors of health, public utilities or state departments or institutions, Public Act No.

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1070 subject to regulations prescribed by the Commissioner of Public Health, and upon payment of any applicable fee as provided in this subsection.

Forsuchpurposesthedepartmentmayprovidenecessarybuildingsand apparatus, employ, subject to the provisions of chapter 67, administrative and scientific personnel and assistants and do all things necessary for the conduct of such laboratories.

The Commissioner of Public Health may establish a schedule of fees, provided the commissioner waives the fees for local directors of health and local law enforcementagencies.Ifthecommissionerestablishesascheduleoffees, the commissioner may waive (1) the fees, in full or in part, for others if the commissioner determines that the public health requires a waiver, and (2) fees for chlamydia and gonorrhea testing for nonprofit organizations and institutions of higher education if the organization or institution provides combination chlamydia and gonorrhea test kits.

The commissioner shall also establish a fair handling fee which a client of a state laboratory may charge a person or third party payer for arranging for the services of the laboratory.

Such client shall not charge an amount in excess of such handling fee.

Sec.

26.

Section 19a-262 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

Each physician, physician assistant and advanced practice registered nurse shall report in writing the name, age, sex, race, ethnicity, occupation, place where last employed, if known, and address of each person under his or her care known or suspected by such physician, physician assistant or advanced practice registered nurse to have tuberculosis, to the Department of Public Health and the director of health of the town, city or borough in which such person resides, [within] not later than twenty-four hours after the physician, physician assistant or advanced practice registered nurse knows or suspects the presence of such disease, and the officer in charge of any hospital, dispensary, asylum or other similar institution shall report in like Public Act No.

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1070 manner concerning each patient having tuberculosis who comes under the care or observation of such officer, [within] not later than twenty- four hours thereafter.

The Commissioner of Public Health and the director of health of each town, city or borough shall keep a record of all such reports received by them, but such records shall not be open to inspection by any person other than the health authorities of the state and of such town, city or borough, and the identity of the person to whom any such report relates shall not be divulged by such health authorities except as may be necessary to carry into effect the provisions of this section, section 19a-263, and section 19a-264.

For purposes of this section and said sections a person may be suspected of having tuberculosis if he or she has (1) an acid fast bacilli identified on a smear of his body fluids or tissue, (2) been prescribed at least two antituberculosis drugs, (3) a preliminary diagnosis which includes ruling out active tuberculosis, or (4) signs or symptoms of active tuberculosis.

Sec.

27.

Section 19a-264 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

The local director of health shall transmit to any physician, physician assistant or advanced practice registered nurse reporting a case or suspected case of tuberculosis as provided in section 19a-262, a printed statement describing such procedure and precautions as are deemed necessary or advisable to be taken on the premises occupied by a tuberculosis patient, and such precautions shall be communicated to the family of the patient.

Any physician licensed pursuant to chapter 370, physician assistant licensed pursuant to chapter 370 or advanced practice registered nurse licensed pursuant to chapter 378, who wilfully makes any false statements in the reports provided for in said section, and any person violating any of the provisions of said section, shall be fined not less than five dollars nor more than fifty dollars or imprisoned not more than six months or be both fined and imprisoned.

Public Act No.

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1070 Sec.

28.

Subsection (b) of section 19a-535 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(b)A facility shallnot transfer or discharge aresident fromthefacility except to meet the welfare of the resident which cannot be met in the facility, or unless the resident no longer needs the services of the facility due to improved health, the facility is required to transfer the resident pursuant to section 17b-359 or 17b-360, or the health or safety of individuals in the facility is endangered, or in the case of a self-pay resident, for theresident'snonpayment or arrearage ofmore thanfifteen days of the per diem facility room rate, or the facility ceases to operate.

In each case the basis for transfer or discharge shall be documented in the resident's medical record by a physician, a physician assistant or an advanced practice registered nurse.

In each case where the welfare, health or safety of the resident is concerned the documentation shall be by the resident's physician, physician assistant or [the resident's] advanced practice registered nurse.

A facility that is part of a continuing care facility which guarantees life care for its residents may transfer or discharge (1) a self-pay resident who is a member of the continuing care community and who has intentionally transferred assets in a sum that will render the resident unable to pay the costs of facility care in accordance with the contract between the resident and the facility, or (2) a self-pay resident who is not a member of the continuing care community and who has intentionally transferred assets in a sum that will render the resident unable to pay the costs of a total of forty-two months of facility care from the date of initial admission to the facility.

Sec.

29.

Subsection (e) of section 19a-535 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(e) Except in an emergency or in the case of transfer to a hospital, no resident shall be transferred or discharged from a facility unless a Public Act No.

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1070 discharge plan has been developed by the personal physician, physician assistant or advanced practice registered nurse of the resident or the medical director in conjunction with the nursing director, social worker or other health care provider.

To minimize the disruptive effects of the transfer or discharge on the resident, the person responsible for developing the plan shall consider the feasibility of placement near the resident'srelatives,theacceptabilityoftheplacementtotheresidentand the resident's guardian or conservator, if any, or the resident's legally liable relative or other responsible party, if known, and any other relevant factors that affect the resident's adjustment to the move.

The plan shall contain a written evaluation of the effects of the transfer or discharge on the resident and a statement of the action taken to minimize such effects.

In addition, the plan shall outline the care and kinds of services that the resident shall receive upon transfer or discharge.

Not less than thirty days prior to an involuntary transfer or discharge, a copy of the discharge plan shall be provided to the resident's personal physician, physician assistant or advanced practice registered nurse if the discharge plan was prepared by the medical director, to the resident and the resident's guardian or conservator, if any, or legally liable relative or other responsible party, if known.

Sec.

30.

Subsections (a) and (b) of section 19a-550 of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(a)(1)Asusedinthissection,(A)"nursinghomefacility"hasthesame meaning as provided in section 19a-521, (B) "residential care home" has the same meaning as provided in section 19a-521, and (C) "chronic disease hospital" means a long-term hospital having facilities, medical staff and all necessary personnel for the diagnosis, care and treatment of chronic diseases;

and (2) for the purposes of subsections (c) and (d) of this section, and subsection (b) of section 19a-537, "medically contraindicated" means a comprehensive evaluation of the impact of a Public Act No.

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1070 potential room transfer on the patient's physical, mental and psychosocial well-being, which determines that the transfer would cause new symptoms or exacerbate present symptoms beyond a reasonable adjustment period resulting in a prolonged or significant negative outcome that could not be ameliorated through care plan intervention, as documented by a physician, physician assistant or an advanced practice registered nurse in a patient's medical record.

(b) There is established a patients' bill of rights for any person admitted asa patient to any nursing home facility,residentialcare home or chronic disease hospital.

The patients' bill of rights shall be implemented in accordance with the provisions of Sections 1919(b), 1919(c), 1919(c)(2), 1919(c)(2)(D) and 1919(c)(2)(E) of the Social Security Act.

The patients' bill of rights shall provide that each such patient:

(1) Is fully informed, as evidenced by the patient's written acknowledgment, prior to or at the time of admission and during the patient's stay, of the rights set forth in this section and of all rules and regulations governing patient conduct and responsibilities;

(2) is fully informed, prior to or at the time of admission and during the patient's stay, ofservicesavailable in suchfacility or chronicdisease hospital,and of related charges including any charges for services not covered under Titles XVIII or XIX of the Social Security Act, or not covered by basic per diemrate;

(3)insuchfacility orhospitalisentitledtochoose thepatient's own physician or advanced practice registered nurse and is fully informed, by a physician or an advanced practice registered nurse, of the patient's medical condition unless medically contraindicated, as documented by the physician, physician assistant or advanced practice registered nurse in the patient's medical record, and is afforded the opportunity to participate in the planning of the patient's medical treatment and to refuse to participate in experimental research;

(4) in a residential care home or a chronic disease hospital is transferred from one room to another within such home or chronic disease hospital only for medical reasons, or for the patient's welfare or that of other patients, Public Act No.

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1070 as documented in the patient's medical record and such record shall include documentation of action taken to minimize any disruptive effectsof suchtransfer, except apatient who is aMedicaidrecipient may be transferred from a private room to a nonprivate room, provided no patient may be involuntarily transferred from one room to another within such home or chronic disease hospital if (A) it is medically established that the move will subject the patient to a reasonable likelihood of serious physical injury or harm, or (B) the patient has a prior established medical history of psychiatric problems and there is psychiatric testimony that as a consequence of the proposed move there will be exacerbation of the psychiatric problem that would last over a significant period of time and require psychiatric intervention;

and in thecaseofaninvoluntarytransferfromoneroomtoanotherwithin such home or chronicdisease hospital,thepatient and,ifknown, thepatient's legally liable relative, guardian or conservator or a person designated by the patient in accordance with section 1-56r, is given not less than thirty days' and not more than sixty days' written notice to ensure orderly transfer from one room to another within such home or chronic disease hospital, except where the health, safety or welfare of other patients is endangered or where immediate transfer from one room to another within such home or chronic disease hospital is necessitated by urgentmedicalneedofthepatient orwhereapatienthasresidedin such home or chronic disease hospital for less than thirty days, in which case notice shall be given as many days before the transfer as practicable;

(5) is encouraged and assisted, throughout the patient's period of stay, to exercise the patient's rights as a patient and as a citizen, and to this end, has the right to be fully informed about patients' rights by state or federally funded patient advocacy programs, and may voice grievances and recommend changes in policies and services to nursing home facility, residential care home or chronic disease hospital staff or to outside representatives of the patient's choice, free from restraint, interference, coercion, discrimination or reprisal;

(6) shall have prompt efforts made by such nursing home facility, residential care home or Public Act No.

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1070 chronic disease hospital to resolve grievances the patient may have, including those with respect to the behavior of other patients;

(7) may manage the patient's personal financial affairs, and is given a quarterly accounting of financial transactions made on the patient's behalf;

(8) is free from mental and physical abuse, corporal punishment, involuntary seclusion and any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the patient's medical symptoms.

Physical or chemical restraints may be imposed only to ensure the physical safety of the patient or other patients and only upon the written order of a physician or an advanced practice registered nurse that specifies the type of restraint and the duration and circumstances under which the restraints are to be used, except in emergencies until a specific order can be obtained;

(9) is assured confidential treatment of the patient's personal and medical records, and may approve or refuse their release to any individual outside the facility, except in case of the patient's transfer to another health care institution or as required by law or third-party payment contract;

(10) receives quality care and services with reasonable accommodation of individual needs and preferences, except where the health or safety of the individual would be endangered, and is treated with consideration, respect, and full recognition of the patient's dignity and individuality, including privacy in treatment and in care for the patient's personal needs;

(11) is not required to perform services for the nursing home facility, residential care home or chronic disease hospital that are not included for therapeutic purposes in the patient's plan of care;

(12) may associate and communicate privately with persons of the patient's choice, including other patients, send and receive the patient's personal mail unopened and make and receive telephone calls privately, unless medically contraindicated, as documented by the patient's physician, physicianassistant or advancedpractice registerednurse inthepatient's medical record, and receives adequate notice before the patient's room or roommate in such facility, home or chronic disease hospital is changed;

(13) is entitled to organize and participate in patient groups in Public Act No.

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1070 such facility, home or chronic disease hospital and to participate in social, religious and community activities that do not interfere with the rights of other patients, unless medically contraindicated, as documented by the patient's physician, physician assistant or advanced practiceregisterednurseinthepatient'smedicalrecords;(14)mayretain and use the patient's personal clothing and possessions unless to do so would infringe upon rights of other patients or unless medically contraindicated, as documented by the patient's physician, physician assistant or advanced practice registered nurse in the patient's medical record;

(15) is assured privacy for visits by the patient's spouse or a person designated by the patient in accordance with section 1-56r and, if the patient is married and both the patient and the patient's spouse are inpatients in the facility, they are permitted to share a room, unless medically contraindicated, as documented by the attending physician, physician assistant or advanced practice registered nurse in the medical record;

(16) is fully informed of the availability of and may examine all current state, local and federal inspection reports and plans of correction;

(17) may organize, maintain and participate in a patient-run resident council, as a means of fostering communication among residents and between residents and staff, encouraging resident independence and addressing the basic rights of nursing home facility, residential care home and chronic disease hospital patients and residents, free from administrative interference or reprisal;

(18) is entitled to the opinion of two physicians concerning the need for surgery, except in an emergency situation, prior to such surgery being performed;

(19) is entitled to have the patient's family or a person designated by the patient in accordance with section 1-56r meet in such facility, residential care home or chronic disease hospital with the families of other patients in the facility to the extent such facility, residential care home or chronic disease hospital has existing meeting space available that meets applicable building and fire codes;

(20) is entitled to file a complaint with the Department of Social Services and the Department of Public Health regarding patient abuse, neglect or Public Act No.

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1070 misappropriation of patient property;

(21) is entitled to have psychopharmacologic drugs administered only on orders of a physician or an advanced practice registered nurse and only as part of a written plan of care developed in accordance with Section 1919(b)(2) of the Social Security Act and designed to eliminate or modify the symptoms for which the drugs are prescribed and only if, at least annually, an independent external consultant reviews the appropriateness of the drug plan;

(22) is entitled to be transferred or discharged from the facility only pursuant to section 19a-535, 19a-535a or 19a-535b, as applicable;

(23) is entitled to be treated equally with other patients with regard to transfer, discharge and the provision of all services regardless of the source of payment;

(24) shall not be required to waive any rights to benefits under Medicare or Medicaid or to give oral or written assurance that thepatient isnot eligiblefor,or willnot apply for benefits under Medicare or Medicaid;

(25) is entitled to be provided information by the nursing home facility or chronic disease hospital as to how to apply for Medicare or Medicaid benefits and how to receive refunds for previous payments covered by such benefits;

(26) is entitled to receive a copy of any Medicare or Medicaid application completed by a nursing homefacility,residentialcarehomeorchronicdiseasehospitalonbehalf of the patient or to designate that a family member, or other representative of the patient, receive a copy of any such application;

(27) on or after October 1, 1990, shall not be required to give a third-party guarantee of payment to the facility as a condition of admission to, or continued stay in, such facility;

(28) is entitled to have such facility not charge, solicit, accept or receive any gift, money, donation, third-party guarantee or other consideration as a precondition of admission or expediting the admission of the individual to such facility or as a requirement for the individual's continued stay in such facility;

and (29) shall not be required to deposit the patient's personal funds in such facility, home or chronic disease hospital.

Sec.

31.

Section 19a-580 of the general statutes is repealed and the Public Act No.

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1070 following is substituted in lieu thereof (Effective October 1, 2021):

Withina reasonable time prior to withholding or causing theremoval of any life support system pursuant to sections 19a-570, 19a-571, 19a-573 and 19a-575 to 19a-580c, inclusive, the attending physician, physician assistant or advanced practice registered nurse shall make reasonable efforts to notify the individual's health care representative, next-of-kin, legal guardian, conservator or person designated in accordance with section 1-56r, if available.

Sec.

32.

Subdivision (12) of section 19a-581 of the general statutes is repealed andthefollowing issubstituted inlieu thereof(EffectiveOctober 1, 2021):

(12) "Health care provider" means any physician, physician assistant, dentist, nurse, provider of services for persons with psychiatric disabilities or persons with intellectual disability or other person involved in providing medical, nursing, counseling, or other health care, substance abuse or mental health service, including such services associated with, or under contract to, ahealthmaintenance organization or medical services plan;

Sec.

33.

Subdivisions (5) to (7), inclusive, of subsection (d) of section 19a-582 of the general statutes are repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(5) In cases where a health care provider or other person, including volunteer emergency medical services, fire and public safety personnel, in the course of his or her occupational duties has had a significant exposure, providedthefollowing criteriaaremet:(A)The worker isable to document significant exposure during performance of his or her occupation, (B) the worker completes an incident report within forty- eight hours of exposure identifying the parties to the exposure, witnesses, time, place and nature of the event, (C) the worker submits Public Act No.

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1070 to a baseline HIV test within seventy-two hours of the exposure and is negative on that test, (D) the patient's or person's physician, physician assistant or advanced practice registered nurse or, if the patient or person does not have a personal physician, physician assistant or advanced practice registered nurse or if the patient's or person's physician, physician assistant or advanced practice registered nurse is unavailable, another physician, physician assistant, advanced practice registered nurse or health care provider has approached the patient or person and sought voluntary consent and the patient or person has refused to consent to testing, except in an exposure where the patient or person is deceased, (E) an exposure evaluation group determines that the criteria specified in subparagraphs (A), (B), (C), (D) and (F) of this subdivision are met and that the worker has a significant exposure to thebloodofapatientorpersonandthepatientorperson,orthepatient's or person's legal guardian, refuses to grant informed consent for an HIV test.

If the patient or person is under the care or custody of the health facility, correctional facility or other institution and a sample of the patient's blood is available, said blood shall be tested.

If no sample of bloodisavailable,andthepatientisunderthecareorcustodyofahealth facility, correctional facility or other institution, the patient shall have a blood sample drawn at the health facility, correctional facility or other institution and tested.

No member of the exposure evaluation group who determines that a worker has sustained a significant exposure and authorized the HIV testing of a patient or other person, nor the health facility, correctional facility or other institution, nor any person in a health facility or other institution who relies in good faith onthe group's determination and performs that test shall have any liability as a result of his or her action carried out pursuant to this section, unless such person acted in bad faith.

If the patient or person is not under the care or custody of a health facility, correctional facility or other institution anda physician, a physicianassistant or anadvancedpractice registered nurse not directly involved in the exposure certifies in writing that the criteria specified in subparagraphs (A), (B), (C), (D) and (F) of this Public Act No.

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1070 subdivision are met and that a significant exposure has occurred, the worker may seek a court order for testing pursuant to subdivision (8) of this subsection, (F) the worker would be able to take meaningful immediate action, if results are known that could not otherwise be taken,asdefinedinregulationsadoptedpursuanttosection19a-589,(G) the fact that an HIV test was given as a result of an accidental exposure and the results of that test shall not appear in a patient's or person's medical record unless such test result is relevant to the medical care the person is receiving at that time in a health facility or correctional facility or other institution, (H)the counseling described in subsection (c) of this section shall be provided but the patient or person may choose not to be informed about the result of the test, and (I) the cost of the HIV test shall be borne by the employer of the potentially exposed worker;

(6)In facilitiesoperatedbytheDepartment ofCorrectionifthefacility physician, physician assistant or advanced practice registered nurse determines that testing is needed for diagnostic purposes, to determine the need for treatment or medical care specific to an HIV-related illness, including prophylactic treatment of HIV infection to prevent further progression of disease, provided no reasonable alternative exists that will achieve the same goal;

(7)In facilitiesoperatedbytheDepartmentofCorrectionifthefacility physician, physicianassistant or advancedpractice registerednurse and chief administrator of the facility determine that the behavior of the inmate poses a significant risk of transmission to another inmate or has resulted in a significant exposure of another inmate of the facility and no reasonable alternative exists that will achieve the same goal.

No involuntary testing shall take place pursuant to this subdivision and subdivision (6) of this subsection until reasonable effort has been made to secure informed consent.

When testing without consent takes place pursuant to this subdivision and subdivision (6) of this subsection, the counseling referrals and notification of test results described in Public Act No.

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1070 subsection (c) of this section shall, nonetheless, be provide;

Sec.

34.

Subsection (a) of section 19a-592 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(a) Any licensed physician, physician assistant or advanced practice registered nurse may examine and provide prophylaxis or treatment for human immunodeficiency virus infection, or acquired immune deficiency syndrome for a minor, only with the consent of the parents or guardian of the minor unless the physician, physician assistant or advanced practice registered nurse determines that notification of the parents or guardian of the minor will result in prophylaxis or treatment being denied or the physician, physician assistant or advanced practice registered nurse determines the minor will not seek, pursue or continue prophylaxis or treatment if the parents or guardian are notified and the minor requests that his or her parents or guardian not be notified.

The physician, physician assistant or advanced practice registered nurse shall fully document the reasons for the determination to provide prophylaxis or treatment without the consent or notification of the parents or guardian of the minor and shall include such documentation, signed by the minor, in the minor's clinical record.

The fact of consultation, examination and prophylaxis or treatment of a minor under the provisions of this section shall be confidential and shall not be divulged without the minor's consent, including the sending of a bill for the services to any person other than the minor until the physician, physician assistant or advanced practice registered nurse consults with the minor regarding the sending of a bill, except (1) for purposes of any report made pursuant to section 19a-215, or (2) if the minor is twelve years of age or younger, the physician, physician assistant or advanced practice registered nurse shall report the name, age and address of the minor to the Commissioner of Children and Families, or the commissioner's designee, who shall classify and evaluate such report Public Act No.

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1070 pursuant to the provisions of section 17a-101g.

As used in this subsection, "prophylaxis" means the use of medication, but does not include the administration of any vaccine, to prevent disease.

Sec.

35.

Section 20-14m of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(a) As used in this section, (1) "long-term antibiotic therapy" means the administration of oral, intramuscular or intravenous antibiotics, singly or incombination,for periodsoftime inexcessoffour weeks;and (2) "Lyme disease" means the clinical diagnosis by a physician, licensed in accordance with chapter 370, a physician assistant, licensed in accordance with chapter 370, or an advanced practice registered nurse, licensed in accordance with chapter 378, of the presence in a patient of signs or symptoms compatible with acute infection with borrelia burgdorferi;

or with late stage or persistent or chronic infection with borrelia burgdorferi, or with complications related to such an infection;

or such other strains of borrelia that, on and after July 1, 2009, are recognized by the National Centers for Disease Control and Prevention as a cause of Lyme disease.

Lyme disease includes an infection that meets the surveillance criteria set forth by the National Centers for Disease Control and Prevention, and other acute and chronic manifestations of such an infection as determined by a physician, licensed in accordance with [the provisions of] chapter 370, a physician assistant, licensed in accordance with chapter 370, or an advanced practice registered nurse, licensed in accordance with chapter 378, pursuant to a clinical diagnosis that is based on knowledge obtained through medical history and physical examination alone, or in conjunction with testing that provides supportive data for such clinical diagnosis.

(b) On and after July 1, 2009, a licensed physician, a licensed physicianassistant or alicensedadvancedpractice registerednursemay prescribe, administer or dispense long-term antibiotic therapy to a Public Act No.

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1070 patient for a therapeutic purpose that eliminates such infection or controls a patient's symptoms upon making a clinical diagnosis that such patient has Lyme disease or displays symptoms consistent with a clinical diagnosis of Lyme disease, provided such clinical diagnosis and treatment are documented in the patient's medical record by such licensed physician, licensed physician assistant or licensed advanced practice registered nurse.

Notwithstanding the provisions of sections 20-8a and 20-13e, on and after said date, the Department of Public Health shall not initiate a disciplinary action against a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse and such physician, physician assistant or advanced practice registered nurse shall not be subject to disciplinary action by the Connecticut Medical Examining Board or the Connecticut State Board of Examiners for Nursing solely for prescribing, administering or dispensing long-termantibiotictherapy to apatient clinically diagnosed with Lyme disease, provided such clinical diagnosis and treatment has been documented in the patient's medical record by such licensed physician, licensed physician assistant or licensed advanced practice registered nurse.

(c) Nothing in this section shall prevent the Connecticut Medical Examining Board or the Connecticut State Board of Examiners for Nursing from taking disciplinary action for other reasons against a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse, pursuant to section 19a-17, or from entering into a consent order with such physician, physician assistant or advanced practice registered nurse pursuant to subsection (c) of section 4-177.

Subject to the limitation set forth in subsection (b) of this section, for purposes of this section, the Connecticut Medical Examining Board may take disciplinary action against a licensed physician if there is any violation of the provisions of section 20-13c or a physician assistant if there is any violation of the provisions of section 20-12f and the Connecticut Board of Examiners for Nursing may take disciplinary Public Act No.

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1070 action against a licensed advanced practice registered nurse in accordance with the provisions of section 20-99.

Sec.

36.

Subsection (e) of section 20-41a of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(e) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, alongwitha certificationby alicensedphysician,alicensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

37.

Subsection (c) of section 20-73b of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(c) The continuing education requirements shall be waived for licensees applying for licensure renewal for the first time.

The department may, for a licensee who has a medical disability or illness, grant a waiver of the continuing education requirements or may grant the licensee an extension of time in which to fulfill the requirements, provided the licensee submits to the Department of Public Health an application for waiver or extension of time on a form prescribed by said Public Act No.

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1070 department, alongwitha certificationby alicensedphysician,alicensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by said department.

The Department of Public Health may grant a waiver or extension for a period not to exceed one registration period, except that said department may grant additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted continues beyond the period of the waiver or extension and the licensee applies to said department for an additional waiver or extension.

Sec.

38.

Subsection (f) of section 20-74ff of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(f) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, alongwitha certificationby alicensedphysician,alicensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

39.

Subsection (f) of section 20-126c of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

Public Act No.

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1070 (f) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, alongwitha certificationby alicensedphysician,alicensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

40.

Subsection (i) of section 20-126l of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(i) In individual cases involving medical disability or illness, the Commissioner of Public Health may grant a waiver of the continuing education requirements or an extension of time within which to fulfill the requirements of this subsection to any licensee, provided the licensee submits to the Department of Public Health an application for waiver or extension of time on a form prescribed by the commissioner, along with a certification by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except the commissioner may grant additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted Public Act No.

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1070 continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

41.

Subsection (e) of section 20-132a of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(e) In individual cases involving medical disability or illness, the Commissioner of Public Health may grant a waiver of the continuing education requirements or an extension of time within which to fulfill the requirements of this section to any licensee, provided the licensee submitstothedepartmentanapplicationforwaiverorextensionoftime on a form prescribed by the commissioner, along with a certification by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissionermaygrantawaiverorextensionforaperiodnottoexceed one registration period, except that the commissioner may grant additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted continues beyond the period of thewaiveror extensionandthelicensee appliesfor anadditionalwaiver or extension.

Sec.

42.

Subsection (e) of section 20-162r of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(e) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, alongwitha certificationby alicensedphysician,alicensed Public Act No.

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1070 physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

43.

Subsection (d) of section 20-191c of the general statutes is repealedandthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(d) A licensee applying for license renewal for the first time shall be exempt from the continuing education requirements under subsection (a) of this section.

In individual cases involving medical disability or illness, the Commissioner of Public Health may grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the commissioner, along with a certification by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may berequired by thecommissioner.The commissioner may grant awaiver or extension for a period not to exceed one registration period, except the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

The commissioner may grant a waiver of the continuing education requirements to a licensee who is not engaged in active professional practice, in any form, during a registration period, provided the licensee submits a notarized Public Act No.

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1070 application on a form prescribed by the commissioner prior to the end of the registration period.

A licensee who is granted a waiver under the provisions of this subsection may not engage in professional practice until the licensee has met the continuing education requirements of this section.

Sec.

44.

Subsection (f) of section 20-201a of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(f) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, alongwitha certificationby alicensedphysician,alicensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

45.

Subdivision (3) of subsection (e) of section 20-206bb of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(3) In individual cases involving medical disability or illness, the commissioner may grant a waiver of the continuing education or certification requirements or an extension of time within which to fulfill such requirements of this subsection to any licensee, provided the Public Act No.

21-196 43 of 80 Senate Bill No.

1070 licensee submits to the department an application for waiver or extension of time on a form prescribed by the commissioner, along with a certification by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the department.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted continues beyond the period of thewaiveror extensionandthelicensee appliesfor anadditionalwaiver or extension.

Sec.

46.

Subsection (f) of section 20-395d of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(f) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department an application for waiver or extension of time on a form prescribed by the department, alongwitha certificationby alicensedphysician,alicensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissioner may grant a waiver or extension for a period not to exceed one registration period, except that the commissioner may grant additional waivers or extensions if the medicaldisability or illnessuponwhichawaiveror extensionisgranted continues beyond the period of the waiver or extension and the licensee applies for an additional waiver or extension.

Sec.

47.

Subdivision (3) of subsection (b) of section 20-402 of the general statutes is repealed and the following is substituted in lieu Public Act No.

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1070 thereof (Effective October 1, 2021):

(3) In individual cases involving medical disability or illness, the commissioner may grant a waiver of the continuing education requirements or an extension of time within which to fulfill such requirements of this subsection to any licensee, provided the licensee submitstothedepartmentanapplicationforwaiverorextensionoftime on a form prescribed by the commissioner, along with a certification by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the department.

The commissionermaygrantawaiverorextensionforaperiodnottoexceed one registration period, except that the commissioner may grant additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted continues beyond the period of thewaiveror extensionandthelicensee appliesfor anadditionalwaiver or extension.

Sec.

48.

Subsection (f) of section 20-411a of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

(f) In individual cases involving medical disability or illness, the commissioner may, in the commissioner's discretion, grant a waiver of the continuing education requirements or an extension of time within which to fulfill the continuing education requirements of this section to any licensee, provided the licensee submits to the department, prior to the expiration of the registration period, an application for waiver on a form prescribed by the department, along with a certification by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse of the disability or illness and such other documentation as may be required by the commissioner.

The commissionermaygrantawaiverorextensionforaperiod nottoexceed one registration period, except that the commissioner may grant Public Act No.

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1070 additional waivers or extensions if the medical disability or illness upon which a waiver or extension is granted continues beyond the period of thewaiveror extensionandthelicensee appliesfor anadditionalwaiver or extension.

Sec.

49.

Section 21a-217 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

Every contract for health club services shall provide that such contract may be cancelled within three business days after the date of receipt by thebuyerofa copy ofthecontract,by writtennotice delivered by certified or registered United States mail to the seller or the seller's agent at an address which shall be specified in the contract.After receipt of such cancellation, the health club may request the return of contract forms, membership cards and any and all other documents and evidenceofmembershippreviouslydeliveredtothebuyer.Cancellation shall be without liability on the part of the buyer, except for the fair marketvalueofservicesactuallyreceivedandthebuyershallbeentitled to a refund of the entire consideration paid for the contract, if any, less the fair market value of the services or use of facilities already actually received.

Such right of cancellation shall not be affected by the terms of the contract and may not be waived or otherwise surrendered.

Such contract for health club services shall also contain a clause providing that if the personreceiving the benefits of such contract relocates further than twenty-five miles from a health club facility operated by the seller or a substantially similar health club facility which would accept the seller's obligation under the contract, or dies during the membership term following the date of such contract, or if the health club ceases operation at the location where the buyer entered into the contract, the buyer or his estate shall be relieved of any further obligation for payment under the contract not then due and owing.

The contract shall also provide that if the buyer becomes disabled during the membership term, the buyer shall have the option of (1) being relieved of liability for Public Act No.

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1070 payment on that portion of the contract term for which he is disabled, or (2) extending the duration of the original contract at no cost to the buyer for a period equal to the duration of thedisability.

The health club shall have the right to require and verify reasonable evidence of relocation, disability or death.

In the case of disability, the health club may require that a certificate signed by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse be submitted as verification and may also require in such contract that the buyer submit to a physical examination by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse agreeable to the buyer and the health club, the cost of which examination shall be borne by the health club.

Sec.

50.

Subdivision (1) of subsection (c) of section 21a-218 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

(c) (1) If the buyer notifies the health club that he has become disabled, the health club shall notify the buyer in writing within fifteen days of receipt by the health club of the buyer's notice of disability and any certificate signed by a licensed physician, physician assistant or a licensed advanced practice registered nurse which may be required under subsection (a) of this section that:

(A) The health club will not require the buyer to submit to another physical examination;

or (B) the health club requires the buyer to submit to another physical examination and that the buyer's obligations under the contract are suspended pending determination of disability.

If the health club fails to send such written notice to the buyer within fifteen days, the health club shall be deemed to have accepted the disability.

Sec.

51.

Subsection (b) of section 22a-616 of the general statutes is repealed andthefollowing issubstituted inlieuthereof(EffectiveOctober 1, 2021):

Public Act No.

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1070 (b) Notwithstanding the provisions of section 22a-617, on and after January 1, 2003, no person shall offer for sale or distribute for promotional purposes mercury fever thermometers except by prescriptionwrittenbyaphysician,aphysicianassistantoranadvanced practice registered nurse.

A manufacturer of mercury fever thermometers shall provide the buyer or the recipient with notice of mercury content, instructions on proper disposal and instructions that clearly describe how to carefully handle the thermometer to avoid breakage and on proper cleanup should a breakage occur.

Sec.

52.

Section 26-29a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

No fee shall be charged for any sport fishing license issued under this chapter to any person with intellectual disability, and such license shall be a lifetime license not subject to the expiration provisions of section 26-35.

Proof of intellectual disability shall consist of a certificate to that effect issued by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse.

Sec.

53.

Section 26-29b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2021):

No fee shall be charged for any hunting, sport fishing or trapping license issued under this chapter to any person with physical disability, and such license shall be a lifetime license not subject to the expiration provisions of section 26-35.

For the purposes of this section, a "person with physical disability" is any person whose disability consists of the loss of one or more limbs or thepermanent loss of the use ofone or more limbs.

A person with physical disability shall submit to the commissioner a certification, signed by a licensed physician, a licensed physician assistant or a licensed advanced practice registered nurse, of suchphysicaldisability.

No feeshallbechargedfor any huntingor sport fishing license issued under this chapter to any person with physical Public Act No.

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1070 disability who is not a resident of this state if such person is a resident of a state in which a person with physical disability from Connecticut will not be required to pay a fee for a hunting or sport fishing license, and such license shall be a lifetime license not subject to the expiration provisions of section 26-35.

Sec.

54.