Regulatory Reminder: New CT Health Care Laws Effective July 1

Pullman & Comley - Connecticut Health Law
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Pullman & Comley - Connecticut Health Law

The most recent legislative session of the Connecticut General Assembly produced a number of new statutory provisions impacting the operations of hospitals, physician groups and other health care providers. To help remind the health care industry of the changes ahead, we’ve highlighted below some of the more noteworthy pieces of legislation that are scheduled to take effect on July 1, 2022.

Protection for Reproductive Health Care Services (PA 22-19)

Among other things, this Public Act allows advanced practice registered nurses (APRNs), nurse-midwives and physician assistants (PAs) to perform aspiration abortions and codifies a 2001 Attorney General Opinion giving these practitioners the right to perform medication abortions. The new law also provides that the decision to terminate a pregnancy before the fetus becomes viable must be made by the patient in consultation with the patient’s physician (as under current law), or the patient’s APRN, nurse-midwife or PA.

In addition, the law prohibits, with exceptions, HIPAA-covered entities from disclosing specified information relating to “reproductive health care services” in a civil action, or a preliminary proceeding before a civil action, or a probate, legislative, or administrative proceeding unless the patient or the patient’s authorized legal representative explicitly consents in writing to such disclosure. Covered entities must inform the patient/representative of the patient’s right to withhold his/her consent.

“Reproductive health care services” includes all medical, surgical, counseling or referral services relating to the human reproductive system, including, but not limited to, services relating to pregnancy, contraception, the termination of a pregnancy or, as added by Section 195 of PA 22-118, all medical care relating to treatment of gender dysphoria.

Combatting the Opioid Epidemic (PA 22-108)

Among the provisions aimed at combatting the opioid crisis, this Act sets forth the process which an authorized practitioner must follow when he/she transports a controlled substance for patient treatment purposes to a location other than the address that the practitioner provided to the Department of Consumer Protection (“DCP”) as a registrant. For example, the new law requires the practitioner to notify DCP of the intent to transport the controlled substance and to report any such dispensation to the prescription drug monitoring program. (Section 3).

Surgical Smoke Evacuation Policies (PA 22-58 § 67)

By January 1, 2024, hospitals and outpatient surgical facilities are required to develop and implement a policy for utilizing a smoke evacuation system to prevent inhalation and exposure to surgical smoke. These facilities must also be prepared to provide a copy of the policy to DPH upon request by that date.

The new law defines “surgical smoke” as the by-product of using an energy-generating device during surgery, such as surgical or smoke plume, bioaerosols, laser-generated airborne contaminants, or lung-damaging dust. The term excludes by-products produced during gastroenterological or ophthalmic procedures that are not emitted into the operating room during surgical procedures.

A “surgical smoke evacuation system” is a system, including but not limited to a smoke or laser plume evacuator or local exhaust ventilator that captures and neutralizes surgical smoke at the site of origin and before the smoke contacts the eyes or respiratory tract of anyone in an operating room during surgery.

Strike Contingency Plans (PA 22-58 § 10)

Under current law (CGS § 19a-497), a licensed health care institution is required to file a strike contingency plan with the Department of Public Health (DPH) commissioner upon being informed of an intention to strike by a labor organization that represents the institution’s employees. The plan must be filed with the commissioner not later than five days before the date indicated for the strike.

New legislation requires the strike contingency plan to include the institution’s staffing plan for at least the first three days of the strike. This entails providing the names and titles of the people who will provide services during the strike period.

Moreover, Medicaid-certified intermediate care facilities for individuals with intellectual disabilities are required to submit the same information in their strike contingency plans as that required of nursing homes (see Regs. Conn. State Agencies §19a-497-1(d)).

Infection Prevention and Control Specialists (PA 22-58 § 52)

New legislation amends the current requirement (CGS § 19a-563) that nursing homes and dementia special care units (i.e., facilities) employ full-time infection prevention and control specialists. Full-time specialists will now be required at facilities with more than 60 residents, whereas facilities with a census below this threshold will only be obligated to employ a part-time specialist.

Further, upon approval of the DPH commissioner, these specialists are now permitted to provide services at both a nursing home and a dementia special care unit or at two nursing homes if the two facilities are: (1) next to each other or occupy the same campus; and (2) commonly owned or operated.

Additionally, the new law provides that the commissioner may waive the law’s infection prevention and control specialist requirements upon a determination that doing so would not endanger the life, safety, or health of a facility’s residents or employees. If a waiver is granted, the commissioner reserves the discretion to impose conditions assuring the health, safety, and welfare of residents and employees and to terminate the waiver if the health, safety, or welfare of said individuals has been jeopardized by such waiver.

Temporary Nursing Services Agencies and Long-Term Care Facilities (PA 22-57)

PA 22-57 repeals the current statutes governing “nursing pools” (CGS §§ 19a-123, 19a-123b and 19a-123d) and requires the DPH commissioner to develop a system, not later than October 1, 2022, for a “temporary nursing services agency” that provides temporary nursing services to health care facilities to register annually with DPH. Among other things, the law also requires these agencies to enter into written agreements with the health care facilities to which they assign their nursing personnel. In addition, the Department of Social Services (DSS), in consultation with DPH, is required to evaluate the rates charged by a temporary nursing services agency to a nursing home facility to determine whether and what changes may be needed in the regulation of such rates to ensure that a nursing home facility has adequate nursing personnel. (Sections 1-4).

The Act also makes changes regarding long-term care facilities. For example, it requires certain nursing facilities and rest homes to report to the Long-Term Care Ombudsman each involuntary discharge or transfer. (Section 9).

Omnibus Budget Bill (PA 22-118)

The omnibus budget bill includes several provisions related to health care that are effective July 1, 2022. Key provisions include:

  • Amendments to the law governing collaborative drug therapy management agreements. The new law also provides for: (1) a “collaborative drug therapy care plan” (a written document memorializing the outcome of the process through which one or more qualified pharmacists and one or more prescribing practitioners discuss, review and agree on an approach to achieve a patient's desired health outcome); and (2) a “collaborative drug therapy management policy” (a written policy adopted by a care-giving institution under which one or more qualified pharmacists manage the drug therapy of, and devices prescribed to, individual patients, or a patient population, based on a written protocol or a collaborative drug therapy care plan) (Sections 69-70).
  • A requirement that pharmacists renew their licenses annually (current law requires biennial renewals) (Section 71).
  • A new immunization information system to replace DPH’s current childhood immunization registry and tracking system. The new system will provide vaccine recipients (or a vaccine recipient’s court-appointed guardian or conservator, if applicable, or, in the case of a child, such child’s parent or guardian) with access to their immunization records (Sections 493-496).

Certificate of Need Process for Long-Term Care Facilities (PA 22-145)

Sections 8 and 9 of this Act amend the certificate of need process for long-term care facilities. For example, the new law allows proposals to build a nontraditional, small-house style nursing home designed to enhance the quality of life for nursing facility residents under certain circumstances. The new law also amends the criteria that DSS must take into account when considering a certificate of need request.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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