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Public Act No. 15-59 AN ACT CONCERNING SCHOOL-BASED HEALTH CENTERS. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. (NEW) (Effective October 1, 2015) (a) As used in sections 19a-6i of the general statutes, as amended by this act, 19a-7d of the general statutes, as amended by this act, and 19a-638 of the general statutes, as amended by this act: (1) "School-based health center" means a health center that: (A) Is located in, or on the grounds of, a school facility of a school district or school board or of an Indian tribe or tribal organization; (B) is organized through school, community and health provider relationships; (C) is administered by a sponsoring facility; and (D) provides comprehensive on-site medical and behavioral health services to children and adolescents in accordance with state and local law, including laws relating to licensure and certification. (2) "Expanded school health site" means a health center that: (A) Is located in, or on the grounds of, a school facility of a school district or school board; (B) is organized through school, community and health provider relationships; (C) is administered by a sponsoring facility; and (D) provides medical or behavioral services, including, but not limited to, dental services, counseling, health education, health

screening and prevention services, to children and adolescents in accordance with state and local law, including laws relating to licensure and certification. (3) "Sponsoring facility" means a: (A) Hospital; (B) public health department; (C) community health center; (D) nonprofit health or human services agency; (E) school or school system; or (F) program administered by the Indian Health Service or the Bureau of Indian Affairs or operated by an Indian tribe or a tribal organization. (b) No person or entity shall use the term "school-based health center" to describe a facility or make use of any words, letters or abbreviations that may reasonably be confused with said term unless the facility meets the definition of a school-based health center in subsection (a) of this section. (c) The Department of Public Health may adopt regulations, in accordance with the provisions of chapter 54 of the general statutes, to establish minimum quality standards for school-based health centers, as defined in subsection (a) of this section. Sec. 2. Subsection (a) of section 19a-6i of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2015): (a) There is established a school-based health center advisory committee for the purpose of advising the Commissioner of Public Health on matters relating to (1) statutory and regulatory changes to improve health care through access to school-based health centers and expanded school health sites, and (2) minimum standards for the provision of services in school-based health centers and expanded school health sites to ensure that high quality health care services are provided in school-based health centers and expanded school health sites, as such terms are defined in section 1 of this act. Public Act No. 15-59 2 of 6

Sec. 3. Subsection (a) of section 19a-7d of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2015): (a) The Commissioner of Public Health may establish, within available appropriations, a program to provide three-year grants to community-based providers of primary care services in order to expand access to health care for the uninsured. The grants may be awarded to community-based providers of primary care for (1) funding for direct services, (2) recruitment and retention of primary care clinicians and registered nurses through subsidizing of salaries or through a loan repayment program, and (3) capital expenditures. The community-based providers of primary care under the direct service program shall provide, or arrange access to, primary and preventive services, referrals to specialty services, including rehabilitative and mental health services, inpatient care, prescription drugs, basic diagnostic laboratory services, health education and outreach to alert people to the availability of services. Primary care clinicians and registered nurses participating in the state loan repayment program or receiving subsidies shall provide services to the uninsured based on a sliding fee schedule, provide free care if necessary, accept Medicare assignment and participate as Medicaid providers, or provide nursing services in school-based health centers and expanded school health sites, as such terms are defined in section 1 of this act. The commissioner may adopt regulations, in accordance with the provisions of chapter 54, to establish eligibility criteria, services to be provided by participants, the sliding fee schedule, reporting requirements and the loan repayment program. For the purposes of this section, "primary care clinicians" includes family practice physicians, general practice osteopaths, obstetricians and gynecologists, internal medicine physicians, pediatricians, dentists, certified nurse midwives, advanced practice registered nurses, physician assistants and dental hygienists. Public Act No. 15-59 3 of 6

Sec. 4. Subsection (b) of section 19a-638 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2015): (b) A certificate of need shall not be required for: (1) Health care facilities owned and operated by the federal government; (2) The establishment of offices by a licensed private practitioner, whether for individual or group practice, except when a certificate of need is required in accordance with the requirements of section 19a- 493b or subdivision (3), (10) or (11) of subsection (a) of this section; (3) A health care facility operated by a religious group that exclusively relies upon spiritual means through prayer for healing; (4) Residential care homes, nursing homes and rest homes, as defined in subsection (c) of section 19a-490; (5) An assisted living services agency, as defined in section 19a-490; (6) Home health agencies, as defined in section 19a-490; (7) Hospice services, as described in section 19a-122b; (8) Outpatient rehabilitation facilities; (9) Outpatient chronic dialysis services; (10) Transplant services; (11) Free clinics, as defined in section 19a-630; (12) School-based health centers and expanded school health sites, as such terms are defined in section 1 of this act, community health centers, as defined in section 19a-490a, not-for-profit outpatient clinics Public Act No. 15-59 4 of 6

licensed in accordance with the provisions of chapter 368v and federally qualified health centers; (13) A program licensed or funded by the Department of Children and Families, provided such program is not a psychiatric residential treatment facility; (14) Any nonprofit facility, institution or provider that has a contract with, or is certified or licensed to provide a service for, a state agency or department for a service that would otherwise require a certificate of need. The provisions of this subdivision shall not apply to a shortterm acute care general hospital or children's hospital, or a hospital or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended; (15) A health care facility operated by a nonprofit educational institution exclusively for students, faculty and staff of such institution and their dependents; (16) An outpatient clinic or program operated exclusively by or contracted to be operated exclusively by a municipality, municipal agency, municipal board of education or a health district, as described in section 19a-241; (17) A residential facility for persons with intellectual disability licensed pursuant to section 17a-227 and certified to participate in the Title XIX Medicaid program as an intermediate care facility for individuals with intellectual disabilities; (18) Replacement of existing imaging equipment if such equipment was acquired through certificate of need approval or a certificate of need determination, provided a health care facility, provider, physician or person notifies the office of the date on which the equipment is replaced and the disposition of the replaced equipment; Public Act No. 15-59 5 of 6

(19) Acquisition of cone-beam dental imaging equipment that is to be used exclusively by a dentist licensed pursuant to chapter 379; (20) The partial or total elimination of services provided by an outpatient surgical facility, as defined in section 19a-493b, except as provided in subdivision (6) of subsection (a) of this section and section 19a-639e; (21) The termination of services for which the Department of Public Health has requested the facility to relinquish its license; or (22) Acquisition of any equipment by any person that is to be used exclusively for scientific research that is not conducted on humans. Approved June 19, 2015 Public Act No. 15-59 6 of 6