Bill Text: CT HB06593 | 2011 | General Assembly | Introduced

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Bill Title: An Act Concerning Residential Care Homes.

Spectrum: Committee Bill

Status: (Introduced - Dead) 2011-03-18 - Public Hearing 03/23 [HB06593 Detail]

Download: Connecticut-2011-HB06593-Introduced.html

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General Assembly		Raised Bill No. 6593
January Session, 2011		LCO No. 4243
		*04243_______PH_*
Referred to Committee on Public Health
Introduced by:
(PH)

AN ACT CONCERNING RESIDENTIAL CARE HOMES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (c) of section 19a-490 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):

(c) "Residential care home" [, "nursing home"] or "rest home" means an establishment which furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services which meet a need beyond the basic provisions of food, shelter and laundry;

Sec. 2. Section 19a-521 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):

As used in this section and sections 19a-522 to 19a-534a, inclusive, 19a-536 to 19a-539, inclusive, 19a-550 to 19a-554, inclusive, and 19a-562a, as amended by this act, unless the context otherwise requires: "Nursing home facility" means any nursing home or [residential care home as defined in section 19a-490 or] any rest home with nursing supervision which provides, in addition to personal care required in a residential care home, nursing supervision under a medical director twenty-four hours per day, or any chronic and convalescent nursing home which provides skilled nursing care under medical supervision and direction to carry out nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages, acute diseases or injuries; "department" means the Department of Public Health; and "commissioner" means the Commissioner of Public Health or the commissioner's designated representative.

Sec. 3. Subsection (a) of section 19a-131k of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):

(a) For purposes of this section:

(1) "Child day care service" means a child day care center, group day care home or family day care home, as defined in section 19a-77, and licensed pursuant to section 19a-80 or 19a-87b;

(2) "Public health emergency" means a public health emergency, as defined in section 19a-131;

(3) "Commissioner" means the Commissioner of Public Health;

(4) "Nursing home facility" means any nursing home, as defined in section 19a-521, as amended by this act; [but shall not include residential care homes;] and

(5) "Youth camp" means any facility licensed pursuant to chapter 368r.

Sec. 4. Subsection (a) of section 19a-562a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):

(a) Each nursing home facility [that is not a residential care home] or [an] Alzheimer's special care unit or program shall annually provide a minimum of two hours of training in pain recognition and administration of pain management techniques to all licensed and registered direct care staff and nurse's aides who provide direct patient care to residents.

Sec. 5. Subdivision (4) of subsection (b) of section 19a-638 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):

(4) Residential care homes [, nursing homes] and rest homes, as defined in subsection (c) of section 19a-490, as amended by this act;

Sec. 6. Section 19a-495a of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2011):

(a) (1) The Commissioner of Public Health shall adopt regulations, [as provided in] pursuant to subsection (d) of this section, to require each residential care home, as defined in section 19a-490, as amended by this act, that admits residents requiring assistance with medication administration, to (A) designate unlicensed personnel to obtain certification for the administration of medication, [and] (B) [to] ensure that such unlicensed personnel receive such certification, and (C) ensure that a registered nurse, licensed in accordance with the provisions of chapter 378, is on-site at the residential care home for not less than five hours per month to supervise the administration of medication by unlicensed personnel.

(2) The regulations shall establish criteria to be used by such homes in determining (A) the appropriate number of unlicensed personnel who shall obtain such certification, and (B) training requirements, including on-going training requirements for such certification. Training requirements shall include, but shall not be limited to: Initial orientation, resident rights, identification of the types of medication that may be administered by unlicensed personnel, behavioral management, personal care, nutrition and food safety, and health and safety in general.

(b) Each residential care home, as defined in section 19a-490, as amended by this act, shall ensure that [, on or before January 1, 2010,] an appropriate number of unlicensed personnel, as determined by the residential care home, obtain certification for the administration of medication. Certification of such personnel shall be in accordance with regulations adopted pursuant to this section. Unlicensed personnel obtaining such certification may administer medications that are not administered by injection to residents of such homes, unless a resident's physician specifies that a medication only be administered by licensed personnel.

(c) [On and after October 1, 2007, unlicensed] Unlicensed assistive personnel employed in residential care homes, as defined in section 19a-490, as amended by this act, may (1) obtain and document residents' blood pressures and temperatures with digital medical instruments that (A) contain internal decision-making electronics, microcomputers or special software that allow the instruments to interpret physiologic signals, and (B) do not require the user to employ any discretion or judgment in their use; (2) obtain and document residents' weight; and (3) assist residents in the use of glucose monitors to obtain and document their blood glucose levels.

(d) The Commissioner of Public Health may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the commissioner prints notice of intent to adopt regulations in the Connecticut Law Journal not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.

Sec. 7. (NEW) (Effective July 1, 2011) (a) On or before January 1, 2012, the Commissioner of Public Health, in consultation with the Commissioner of Social Services, shall establish and operate a medical model pilot program that shall permit the operator of a residential care home to utilize the services of a licensed registered nurse to provide health care services to the residents of such homes. Pilot program services may be offered in not more than ten residential care homes in the state. In selecting residential care homes to participate in the pilot program, the Commissioner of Public Health shall give due consideration to implementation of the pilot program in various geographic regions of the state.

(b) Under the pilot program, the operator of a residential care home may utilize the services of a licensed registered nurse to provide not more than twenty hours of health care services on a weekly basis to residents of such home. Services provided under the pilot program shall be for residents who are most at risk for nursing home placement. Services provided under the pilot program may include, but shall not be limited to, mobility assistance, incontinence care and specialized services that assist persons with psychiatric illnesses, dementia or early onset of Alzheimer's Disease. All services provided by a licensed registered nurse shall be within such nurse's scope of practice as set forth in section 20-87a of the general statutes.

(c) The Commissioner of Public Health shall ensure that the annual per recipient cost to the state to provide pilot program services does not exceed the annual per recipient cost to the state to provide nursing home care to such residents. Not later than January 1, 2014, the Commissioner of Public Health shall report, in accordance with section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health, human services and appropriations and the budgets of state agencies on the pilot program.

This act shall take effect as follows and shall amend the following sections:
Section 1	October 1, 2011	19a-490(c)
Sec. 2	October 1, 2011	19a-521
Sec. 3	October 1, 2011	19a-131k(a)
Sec. 4	October 1, 2011	19a-562a(a)
Sec. 5	October 1, 2011	19a-638(b)(4)
Sec. 6	October 1, 2011	19a-495a
Sec. 7	July 1, 2011	New section

Statement of Purpose:

To: (1) Amend various statutes that include a residential care home within the definition of nursing home, (2) require that, for not less than five hours per month, a registered nurse shall supervise the administration of medication by unlicensed personnel in residential care homes, and (3) establish a medical model, residential care home pilot program that will allow persons in residential care homes to receive in-home health care services in order to avoid placement in nursing homes.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]