LCO No. 5937 1 of 6
General Assembly Raised Bill No. 1087
January Session, 2021
LCO No. 5937
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING TH E RECRUITMENT AND RE TENTION OF
HEALTH CARE PROVIDER S IN THE STATE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-7d of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective July 1, 2021): 2
(a) [The] Not later than January 1, 2022, the Commissioner of Public 3
Health [may] shall establish, within available appropriations, a program 4
to provide three-year grants to community-based providers of primary 5
care services in order to expand access to health care for the uninsured. 6
The grants may be awarded to community-based providers of primary 7
care for (1) funding for direct services, (2) recruitment and retention of 8
primary care clinicians and registered nurses through subsidizing of 9
salaries or through a loan repayment program, and (3) capital 10
expenditures. The community-based providers of primary care under 11
the direct service program shall provide, or arrange access to, primary 12
and preventive services, referrals to specialty services, including 13
rehabilitative and mental health services, inpatient care, prescription 14
drugs, basic diagnostic laboratory services, health education and 15 Raised Bill No. 1087
LCO No. 5937 2 of 6
outreach to alert people to the availability of services. Primary care 16
clinicians and registered nurses participating in the state loan 17
repayment program or receiving subsidies shall provide services to the 18
uninsured based on a sliding fee schedule, provide free care if necessary, 19
accept Medicare assignment and participate as Medicaid providers, or 20
provide nursing services in school-based health centers and expanded 21
school health sites, as such terms are defined in section 19a-6r. The 22
commissioner may adopt regulations, in accordance with the provisions 23
of chapter 54, to establish eligibility criteria, services to be provided by 24
participants, the sliding fee schedule, reporting requirements and the 25
loan repayment program. For the purposes of this section, "primary care 26
clinicians" includes family practice physicians, general practice 27
osteopaths, obstetricians and gynecologists, internal medicine 28
physicians, pediatricians, dentists, certified nurse midwives, advanced 29
practice registered nurses, registered nurses, alcohol and drug 30
counselors, pharmacists, mental health care providers, physician 31
assistants and dental hygienists. 32
(b) Funds appropriated for the state loan repayment program shall 33
not lapse until fifteen months following the end of the fiscal year for 34
which such funds were appropriated. 35
Sec. 2. Section 20-14p of the general statutes is repealed and the 36
following is substituted in lieu thereof (Effective July 1, 2021): 37
(a) For purposes of this section: (1) "Covenant not to compete" means 38
any provision of an employment or other contract or agreement that 39
creates or establishes a professional relationship with a physician and 40
restricts the right of a physician to practice medicine in any geographic 41
area of the state for any period of time after the termination or cessation 42
of such partnership, employment or other professional relationship; (2) 43
"physician" means an individual licensed to practice medicine under 44
this chapter; and (3) "primary site where such physician practices" 45
means (A) the office, facility or location where a majority of the revenue 46
derived from such physician's services is generated, or (B) any other 47
office, facility or location where such physician practices and mutually 48 Raised Bill No. 1087
LCO No. 5937 3 of 6
agreed to by the parties and identified in the covenant not to compete. 49
(b) (1) A covenant not to compete that is entered into, amended, 50
extended or renewed prior to July 1, 2021, is valid and enforceable only 51
if it is: (A) Necessary to protect a legitimate business interest; (B) 52
reasonably limited in time, geographic scope and practice restrictions as 53
necessary to protect such business interest; and (C) otherwise consistent 54
with the law and public policy. The party seeking to enforce a covenant 55
not to compete shall have the burden of proof in any proceeding. 56
(2) A covenant not to compete that is entered into, amended, 57
extended or renewed on or after July 1, 2016, shall not: (A) Restrict the 58
physician's competitive activities (i) for a period of more than one year, 59
and (ii) in a geographic region of more than fifteen miles from the 60
primary site where such physician practices; or (B) be enforceable 61
against a physician if (i) such employment contract or agreement was 62
not made in anticipation of, or as part of, a partnership or ownership 63
agreement and such contract or agreement expires and is not renewed, 64
unless, prior to such expiration, the employer makes a bona fide offer to 65
renew the contract on the same or similar terms and conditions, or (ii) 66
the employment or contractual relationship is terminated by the 67
employer, unless such employment or contractual relationship is 68
terminated for cause. 69
(3) Each covenant not to compete entered into, amended or renewed 70
on and after July 1, 2016, until June 30, 2021, shall be separately and 71
individually signed by the physician. 72
(4) On and after July 1, 2021, no employment, partnership or 73
ownership contract or agreement entered into, amended or renewed 74
shall contain a covenant not to compete and each covenant not to 75
compete entered into, amended or renewed on and after said date shall 76
be void and unenforceable. Any physician who is aggrieved by a 77
violation of this subdivision may bring a civil action in the Superior 78
Court to recover damages, together with court costs and reasonable 79
attorney's fees, and for such injunctive and equitable relief as the court 80 Raised Bill No. 1087
LCO No. 5937 4 of 6
deems appropriate. 81
(c) The remaining provisions of any contract or agreement that 82
includes a covenant not to compete that is rendered void and 83
unenforceable, in whole or in part, under the provisions of this section 84
shall remain in full force and effect, including provisions that require 85
the payment of damages resulting from any injury suffered by reason of 86
termination of such contract or agreement. 87
Sec. 3. (Effective from passage) (a) As used in this section, "federally-88
qualified health center" has the same meaning as provided in Section 89
1905(l)(2)(B) of the Social Security Act, 42 USC 1396d(l)(2)(B), as 90
amended from time to time. 91
(b) Not later than January 1, 2022, the Department of Public Health 92
shall establish a five-year pilot program for the recruitment and 93
retention by federally-qualified health centers in the state of mental 94
health care providers, including, but not limited to, psychiatrists 95
licensed pursuant to chapter 370 of the general statutes, psychologists 96
licensed pursuant to chapter 383 of the general statutes and advanced 97
practice registered nurses licensed pursuant to chapter 378 of the 98
general statutes who are board certified as a psychiatric mental health 99
provider by the American Nurses Credentialing Center . The 100
Commissioner of Public Health shall (1) prescribe the form and manner 101
in which a federally-qualified health center may apply to the 102
department to participate in the pilot program, (2) establish the criteria 103
to be used by the department in selecting federally-qualified health 104
centers to participate in the pilot program, which shall include, but need 105
not be limited to, prioritizing the placement of mental health care 106
providers in areas of the state where (A) there is the greatest need for 107
such providers, (B) there are economically distressed municipalities, 108
and (C) residents do not have access to mental health care within close 109
proximity to their homes, and (3) explore the means of funding the pilot 110
program through public-private partnerships, grant programs, federal 111
funds and state funds. 112 Raised Bill No. 1087
LCO No. 5937 5 of 6
(c) Not later than January 1, 2023, and annually thereafter until 113
January 1, 2027, the Commissioner of Public Health shall submit a 114
report, in accordance with the provisions of section 11-4a of the general 115
statutes, containing an evaluation of the operation and effectiveness of 116
the pilot program to the joint standing committee of the General 117
Assembly having cognizance of matters relating to public health. 118
Sec. 4. (NEW) (Effective July 1, 2021) (a) For the fiscal year ending June 119
30, 2021, and each fiscal year thereafter, the Office of Higher Education 120
shall, within available appropriations, administer a mental health care 121
provider loan reimbursement grant program for persons who meet the 122
eligibility requirements described in subsection (b) of this section. 123
(b) The program shall provide student loan reimbursement grants to 124
any person who (1) is a psychiatrist licensed pursuant to chapter 370 of 125
the general statutes, a psychologist licensed pursuant to chapter 383 of 126
the general statutes or an advanced practice registered nurse licensed 127
pursuant to chapter 378 of the general statutes who is board certified as 128
a psychiatric mental health provider by the American Nurses 129
Credentialing Center, and (2) is employed as a mental health care 130
provider by a federally-qualified health center in the state for not less 131
than two years. 132
(c) Any person who satisfies the eligibility requirements prescribed 133
in subsection (b) of this section may receive an annual grant for 134
reimbursement of federal or state educational loans (1) in an amount not 135
to exceed twenty-five thousand dollars in any year, and (2) for a period 136
not to exceed two years. Such person shall only be reimbursed for loan 137
payments made while such person is employed by a federally-qualified 138
health center. 139
(d) Persons may apply to the Office of Higher Education for grants 140
under this section at such time and in such manner as the executive 141
director of the Office of Higher Education prescribes. 142
(e) Any unexpended funds appropriated for purposes of this section 143
shall not lapse at the end of the fiscal year but shall be available for 144 Raised Bill No. 1087
LCO No. 5937 6 of 6
expenditure during the next fiscal year. 145
(f) The Office of Higher Education may accept gifts, grants and 146
donations, from any source, public or private, for the mental health care 147
provider loan reimbursement grant program. 148
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2021 19a-7d
Sec. 2 July 1, 2021 20-14p
Sec. 3 from passage New section
Sec. 4 July 1, 2021 New section
Statement of Purpose:
To recruit and retain health care professionals in the state.
[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.]