Connecticut Governor Ned Lamont recently signed into law Public Act No. 22-58, “An Act Concerning the Department of Public Health’s Recommendations Regarding Various Revisions to the Public Health Statutes” (the Act). The Act is an omnibus bill that includes a number of notable updates to state laws concerning health care and hospitals, certain of which are summarized below.

Changes Effective from Passage (May 23, 2022)

• Health care facilities (including hospitals, outpatient clinics, long-term care facilities, and hospice facilities) are required, starting January 1, 2023, to take into consideration technical accessibility standards developed by the federal Architectural and Transportation Barriers Compliance Board when purchasing medical diagnostic equipment.

• The Office of Health Strategy’s (OHS) Executive Director is directed to adopt regulations to implement the state’s health information exchange and to adopt interim policies and procedures (after holding a hearing and posting notice of such policies and procedures) applicable to health information exchange participation until such regulations are finalized.

Changes Effective July 1, 2022

• Hospitals and outpatient surgical facilities are required, by January 1, 2024, to develop and implement policies for the use of a surgical smoke evacuation system to prevent exposure to surgical smoke.

• The Act sets forth new requirements regarding what must be included in a health care institution’s strike contingency plan.  Currently, institutions (including hospitals) are required to file a strike contingency plan with the Department of Public Health (DPH) after receiving a notice of intention to strike from a labor organization. Under the Act, the strike contingency plan must describe the institution’s staffing plan for at least the first three days of the strike and include the names and titles of individuals who will be providing services at the institution.

• The Act makes a change to state nursing home infection control requirements to provide that nursing homes and dementia special care units with more than 60 residents are required to employ a full-time infection prevention and control specialist, whereas such homes and units with 60 or fewer residents must employ a part-time infection prevention and control specialist. Previously, all nursing homes and dementia special care units had to employ such a specialist full-time. The Act also allows the DPH Commissioner to waive requirements of this law where doing so would not endanger the life, safety or health of any resident or employee.

Changes Effective October 1, 2022

• The Act makes a number of changes to Connecticut General Statutes § 19a-490, which set forth key definitions (including the definition of a health care “institution”) governing DPH’s regulatory oversight of health care facilities in Connecticut, including the following:

  • Newly includes a “clinical laboratory” within the definition of a health care “institution,” codifying applicability of regulatory requirements for health care institutions to laboratories in Connecticut.

    • “Clinical laboratory” is defined as “any facility or other area used for microbiological, serological, chemical, hematological, immunohematological, biophysical, cytological, pathological or other examinations of human body fluids, secretions, excretions or excised or exfoliated tissues for the purpose of providing information for the (1) diagnosis, prevention or treatment of any human disease or impairment, (2) assessment of human health, or (3) assessment of the presence of drugs, poisons or other toxicological substances.”

  • Newly defines the term “chronic disease hospital” as a “long-term hospital having facilities, medical staff and all necessary personnel for the diagnosis, care and treatment of chronic diseases” and makes corresponding statutory changes to use that term (as well as to remove that definition from General Statutes § 19a-550).

  • Removes the defined term “alcohol or drug treatment facility” from that statute and makes corresponding changes to remove it from other statutes in favor of the term “behavioral health facility” (which was already defined in General Statutes § 19a-490).

• The Act expands HIV testing of persons 13 years of age or older as follows:

  • The Act newly requires primary care providers (or their designees) to offer HIV testing for all patients 13 years of age or older, starting on January 1, 2023, except where the patient (i) is receiving life-threatening emergency treatment, (ii) has previously been offered or received an HIV test, or (iii) lacks the capacity to consent to HIV testing.

  • The Act newly requires hospitals treating patients 13 years of age or older in the emergency department to offer HIV testing to such patients, starting on January 1, 2024, except where the patient (i) is receiving life-threatening emergency treatment, (ii) has previously been offered or received an HIV test, (iii) lacks the capacity to consent to HIV testing, or (iv) declines the test. Hospitals are required to develop protocols to implement the foregoing requirement by January 1, 2024, including for the tracking of testing and reporting of positive results to DPH.

• The Act adds language to specify that unlicensed personnel who may be certified to administer medication in residential care homes must be certified and then recertified every two years by one of DPH, the Department of Children and Families, or the Department of Developmental Services. Currently, such unlicensed personnel must be recertified every three years.

• The Act expressly permits clinical medical assistants to administer vaccines “under the supervision, control and responsibility of” a licensed physician, physician assistant (PA), or advanced practice nurse practitioner (APRN) in any setting other than the hospital. Notably, the Act states that nothing in this new law should be construed to permit an employer of a physician, PA, or APRN to require such practitioner to oversee a clinical medical assistant administering vaccines without the consent of the physician, PA, or APRN.

  • The term “clinical medical assistant” is defined to refer to a person certified by the American Association of Medical Assistants, the National Healthcareer Association, the National Center for Competency Testing, or the American Medical Technologists and who meets certain training and/or education pre-requisites.

  • In order to administer vaccines, the clinical medical assistant must complete at least 24 hours of classroom training and eight hours of clinical training regarding the administration of vaccines.

• The Act expands the procedure that must be afforded for a residential care home to involuntarily transfer or discharge a resident, including in an emergency. The Act also provides that if a resident appeals an involuntary discharge or transfer, such action shall be paused until a final determination by DPH, and the resident may then appeal an adverse determination to the Connecticut Superior Court. In addition, in the case of an involuntary transfer or discharge requested by a facility in an “emergency” (newly defined as “a situation in which a resident of a facility presents an imminent danger to the resident’s own health or safety, the health or safety of another resident or the health or safety of an employee or the owner of the facility”), the DPH Commissioner may issue a temporary order pending a final decision, and the resident is afforded a hearing prior to issuance of a final decision.

• The Act newly permits the Office of the Chief Medical Examiner to take custody and coordinate disposition of deceased bodies in certain circumstances, after undertaking reasonable efforts to identify any living relatives of the deceased for not less than 21 days.

Changes Effective January 1, 2023

• The Act updates and significantly expands mandatory Community Benefit Program reporting by licensed hospitals in the state, and empowers OHS to oversee such reporting.  Among other requirements, the Act directs that:

  • Hospitals must submit their Community Health Needs Assessment (CHNA) to OHS within 30 days of making the CHNA publicly available, in accordance with federal law (Section 501(r) of the Internal Revenue Code), and the CHNA submission must include information on how the hospital defined its community and assessed and prioritized its needs, among other requirements, as well as documentation identifying the individuals responsible for the CHNA, and demographic and health status information relevant to achieving the goals of the CHNA.

  • Hospitals must submit an implementation strategy for implementing the CHNA within 30 days of adoption of the strategy by the Hospital, which identifies health needs and describes plans to address (or not address) such needs. The strategy must be accompanied by documentation identifying the individuals responsible for developing the strategy, a description of community involvement with the implementation, a description of how community needs and disparities were prioritized, with supporting evidence if available, and plans for ongoing evaluation of the implementation.

  • Hospitals must submit to OHS, by October 1, 2023, and annually thereafter, a status report on each hospital’s Community Benefit Program.

  • OHS must make data in the state’s all-payer claims database available to hospitals for use in Community Benefit Programs and reporting.

  • For-profit hospitals not directly subject to Section 501(r) of the Internal Revenue Code (and thus its CHNA requirements) are obligated to submit Community Benefit Program reporting consistent with the reporting obligations applicable to non-profit exempt hospitals under the Act.