Connecticut 2021 Regular Session

Connecticut Senate Bill SB01087 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 1087
	4	+	LCO No. 5937 1 of 6
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	6	+	General Assembly Raised Bill No. 1087
8	7		January Session, 2021
	8	+	LCO No. 5937
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	10	+
	11	+	Referred to Committee on PUBLIC HEALTH
	12	+
	13	+
	14	+	Introduced by:
	15	+	(PH)
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14	20		AN ACT CONCERNING TH E RECRUITMENT AND RE TENTION OF
15	21		HEALTH CARE PROVIDER S IN THE STATE.
16	22		Be it enacted by the Senate and House of Representatives in General
17	23		Assembly convened:
18	24
19	25		Section 1. Section 19a-7d of the general statutes is repealed and the 1
20	26		following is substituted in lieu thereof (Effective July 1, 2021): 2
21	27		(a) [The] Not later than January 1, 2022, the Commissioner of Public 3
22	28		Health [may] shall establish, within available appropriations, a program 4
23	29		to provide three-year grants to community-based providers of primary 5
24	30		care services in order to expand access to health care for the uninsured. 6
25	31		The grants may be awarded to community-based providers of primary 7
26	32		care for (1) funding for direct services, (2) recruitment and retention of 8
27		-	primary care clinicians [and registered nurses] through subsidizing of 9
	33	+	primary care clinicians and registered nurses through subsidizing of 9
28	34		salaries or through a loan repayment program, and (3) capital 10
29	35		expenditures. The community-based providers of primary care under 11
30	36		the direct service program shall provide, or arrange access to, primary 12
31	37		and preventive services, referrals to specialty services, including 13
32	38		rehabilitative and mental health services, inpatient care, prescription 14
33		-	drugs, basic diagnostic laboratory services, health education and 15
34		-	outreach to alert people to the availability of services. Primary care 16
35		-	clinicians [and registered nurses] participating in the state loan 17
36		-	repayment program or receiving subsidies shall provide services to the 18 Substitute Bill No. 1087
	39	+	drugs, basic diagnostic laboratory services, health education and 15 Raised Bill No. 1087
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	45	+	outreach to alert people to the availability of services. Primary care 16
	46	+	clinicians and registered nurses participating in the state loan 17
	47	+	repayment program or receiving subsidies shall provide services to the 18
43	48		uninsured based on a sliding fee schedule, provide free care if necessary, 19
44	49		accept Medicare assignment and participate as Medicaid providers, or 20
45	50		provide nursing services in school-based health centers and expanded 21
46	51		school health sites, as such terms are defined in section 19a-6r. The 22
47	52		commissioner may adopt regulations, in accordance with the provisions 23
48	53		of chapter 54, to establish eligibility criteria, services to be provided by 24
49	54		participants, the sliding fee schedule, reporting requirements and the 25
50	55		loan repayment program. For the purposes of this section, "primary care 26
51	56		clinicians" includes family practice physicians, general practice 27
52	57		osteopaths, obstetricians and gynecologists, internal medicine 28
53	58		physicians, pediatricians, dentists, certified nurse midwives, advanced 29
54	59		practice registered nurses, registered nurses, alcohol and drug 30
55	60		counselors, pharmacists, mental health care providers, physician 31
56	61		assistants and dental hygienists. 32
57	62		(b) Funds appropriated for the state loan repayment program shall 33
58	63		not lapse until fifteen months following the end of the fiscal year for 34
59	64		which such funds were appropriated. 35
60		-	Sec. 2. (Effective from passage) (a) As used in this section, "federally-36
61		-	qualified health center" has the same meaning as provided in Section 37
62		-	1905(l)(2)(B) of the Social Security Act, 42 USC 1396d(l)(2)(B), as 38
63		-	amended from time to time. 39
64		-	(b) Not later than January 1, 2022, the Department of Public Health 40
65		-	shall establish a five-year pilot program for the recruitment and 41
66		-	retention by federally-qualified health centers in the state of mental 42
67		-	health care providers, including, but not limited to, psychiatrists 43
68		-	licensed pursuant to chapter 370 of the general statutes, psychologists 44
69		-	licensed pursuant to chapter 383 of the general statutes and advanced 45
70		-	practice registered nurses licensed pursuant to chapter 378 of the 46
71		-	general statutes who are board certified as psychiatric mental health 47
72		-	providers by the American Nurses Credentialing Center. The 48
73		-	Commissioner of Public Health shall (1) prescribe the form and manner 49
74		-	in which a federally-qualified health center may apply to the 50
75		-	department to participate in the pilot program, (2) establish the criteria 51 Substitute Bill No. 1087
	65	+	Sec. 2. Section 20-14p of the general statutes is repealed and the 36
	66	+	following is substituted in lieu thereof (Effective July 1, 2021): 37
	67	+	(a) For purposes of this section: (1) "Covenant not to compete" means 38
	68	+	any provision of an employment or other contract or agreement that 39
	69	+	creates or establishes a professional relationship with a physician and 40
	70	+	restricts the right of a physician to practice medicine in any geographic 41
	71	+	area of the state for any period of time after the termination or cessation 42
	72	+	of such partnership, employment or other professional relationship; (2) 43
	73	+	"physician" means an individual licensed to practice medicine under 44
	74	+	this chapter; and (3) "primary site where such physician practices" 45
	75	+	means (A) the office, facility or location where a majority of the revenue 46
	76	+	derived from such physician's services is generated, or (B) any other 47
	77	+	office, facility or location where such physician practices and mutually 48 Raised Bill No. 1087
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82		-	to be used by the department in selecting federally-qualified health 52
83		-	centers to participate in the pilot program, which shall include, but need 53
84		-	not be limited to, prioritizing the placement of mental health care 54
85		-	providers in areas of the state where (A) there is the greatest need for 55
86		-	such providers, (B) there are economically distressed municipalities, 56
87		-	and (C) residents do not have access to mental health care within close 57
88		-	proximity to their homes, and (3) explore the means of funding the pilot 58
89		-	program through public-private partnerships, grant programs, federal 59
90		-	funds and state funds. 60
91		-	(c) Not later than January 1, 2023, and annually thereafter until 61
92		-	January 1, 2027, the Commissioner of Public Health shall submit a 62
93		-	report, in accordance with the provisions of section 11-4a of the general 63
94		-	statutes, containing an evaluation of the operation and effectiveness of 64
95		-	the pilot program to the joint standing committee of the General 65
96		-	Assembly having cognizance of matters relating to public health. 66
97		-	Sec. 3. (NEW) (Effective July 1, 2021) (a) For the fiscal year ending June 67
98		-	30, 2021, and each fiscal year thereafter, the Office of Higher Education 68
99		-	shall, within available appropriations, administer a mental health care 69
100		-	provider loan reimbursement grant program for persons who meet the 70
101		-	eligibility requirements described in subsection (b) of this section. 71
102		-	(b) The program shall provide student loan reimbursement grants to 72
103		-	any person who (1) is a psychiatrist licensed pursuant to chapter 370 of 73
104		-	the general statutes, a psychologist licensed pursuant to chapter 383 of 74
105		-	the general statutes or an advanced practice registered nurse licensed 75
106		-	pursuant to chapter 378 of the general statutes who is board certified as 76
107		-	a psychiatric mental health provider by the American Nurses 77
108		-	Credentialing Center, and (2) is employed as a mental health care 78
109		-	provider by a federally-qualified health center in the state for not less 79
110		-	than two years. 80
111		-	(c) Any person who satisfies the eligibility requirements prescribed 81
112		-	in subsection (b) of this section may receive an annual grant for 82
113		-	reimbursement of federal or state educational loans (1) in an amount not 83 Substitute Bill No. 1087
	81	+	LCO No. 5937 3 of 6
	82	+
	83	+	agreed to by the parties and identified in the covenant not to compete. 49
	84	+	(b) (1) A covenant not to compete that is entered into, amended, 50
	85	+	extended or renewed prior to July 1, 2021, is valid and enforceable only 51
	86	+	if it is: (A) Necessary to protect a legitimate business interest; (B) 52
	87	+	reasonably limited in time, geographic scope and practice restrictions as 53
	88	+	necessary to protect such business interest; and (C) otherwise consistent 54
	89	+	with the law and public policy. The party seeking to enforce a covenant 55
	90	+	not to compete shall have the burden of proof in any proceeding. 56
	91	+	(2) A covenant not to compete that is entered into, amended, 57
	92	+	extended or renewed on or after July 1, 2016, shall not: (A) Restrict the 58
	93	+	physician's competitive activities (i) for a period of more than one year, 59
	94	+	and (ii) in a geographic region of more than fifteen miles from the 60
	95	+	primary site where such physician practices; or (B) be enforceable 61
	96	+	against a physician if (i) such employment contract or agreement was 62
	97	+	not made in anticipation of, or as part of, a partnership or ownership 63
	98	+	agreement and such contract or agreement expires and is not renewed, 64
	99	+	unless, prior to such expiration, the employer makes a bona fide offer to 65
	100	+	renew the contract on the same or similar terms and conditions, or (ii) 66
	101	+	the employment or contractual relationship is terminated by the 67
	102	+	employer, unless such employment or contractual relationship is 68
	103	+	terminated for cause. 69
	104	+	(3) Each covenant not to compete entered into, amended or renewed 70
	105	+	on and after July 1, 2016, until June 30, 2021, shall be separately and 71
	106	+	individually signed by the physician. 72
	107	+	(4) On and after July 1, 2021, no employment, partnership or 73
	108	+	ownership contract or agreement entered into, amended or renewed 74
	109	+	shall contain a covenant not to compete and each covenant not to 75
	110	+	compete entered into, amended or renewed on and after said date shall 76
	111	+	be void and unenforceable. Any physician who is aggrieved by a 77
	112	+	violation of this subdivision may bring a civil action in the Superior 78
	113	+	Court to recover damages, together with court costs and reasonable 79
	114	+	attorney's fees, and for such injunctive and equitable relief as the court 80 Raised Bill No. 1087
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120		-	to exceed twenty-five thousand dollars in any year, and (2) for a period 84
121		-	not to exceed two years. Such person shall only be reimbursed for loan 85
122		-	payments made while such person is employed by a federally-qualified 86
123		-	health center. 87
124		-	(d) Persons may apply to the Office of Higher Education for grants 88
125		-	under this section at such time and in such manner as the executive 89
126		-	director of the Office of Higher Education prescribes. 90
127		-	(e) Any unexpended funds appropriated for purposes of this section 91
128		-	shall not lapse at the end of the fiscal year but shall be available for 92
129		-	expenditure during the next fiscal year. 93
130		-	(f) The Office of Higher Education may accept gifts, grants and 94
131		-	donations, from any source, public or private, for the mental health care 95
132		-	provider loan reimbursement grant program.96
	118	+	LCO No. 5937 4 of 6
	119	+
	120	+	deems appropriate. 81
	121	+	(c) The remaining provisions of any contract or agreement that 82
	122	+	includes a covenant not to compete that is rendered void and 83
	123	+	unenforceable, in whole or in part, under the provisions of this section 84
	124	+	shall remain in full force and effect, including provisions that require 85
	125	+	the payment of damages resulting from any injury suffered by reason of 86
	126	+	termination of such contract or agreement. 87
	127	+	Sec. 3. (Effective from passage) (a) As used in this section, "federally-88
	128	+	qualified health center" has the same meaning as provided in Section 89
	129	+	1905(l)(2)(B) of the Social Security Act, 42 USC 1396d(l)(2)(B), as 90
	130	+	amended from time to time. 91
	131	+	(b) Not later than January 1, 2022, the Department of Public Health 92
	132	+	shall establish a five-year pilot program for the recruitment and 93
	133	+	retention by federally-qualified health centers in the state of mental 94
	134	+	health care providers, including, but not limited to, psychiatrists 95
	135	+	licensed pursuant to chapter 370 of the general statutes, psychologists 96
	136	+	licensed pursuant to chapter 383 of the general statutes and advanced 97
	137	+	practice registered nurses licensed pursuant to chapter 378 of the 98
	138	+	general statutes who are board certified as a psychiatric mental health 99
	139	+	provider by the American Nurses Credentialing Center . The 100
	140	+	Commissioner of Public Health shall (1) prescribe the form and manner 101
	141	+	in which a federally-qualified health center may apply to the 102
	142	+	department to participate in the pilot program, (2) establish the criteria 103
	143	+	to be used by the department in selecting federally-qualified health 104
	144	+	centers to participate in the pilot program, which shall include, but need 105
	145	+	not be limited to, prioritizing the placement of mental health care 106
	146	+	providers in areas of the state where (A) there is the greatest need for 107
	147	+	such providers, (B) there are economically distressed municipalities, 108
	148	+	and (C) residents do not have access to mental health care within close 109
	149	+	proximity to their homes, and (3) explore the means of funding the pilot 110
	150	+	program through public-private partnerships, grant programs, federal 111
	151	+	funds and state funds. 112 Raised Bill No. 1087
	152	+
	153	+
	154	+
	155	+	LCO No. 5937 5 of 6
	156	+
	157	+	(c) Not later than January 1, 2023, and annually thereafter until 113
	158	+	January 1, 2027, the Commissioner of Public Health shall submit a 114
	159	+	report, in accordance with the provisions of section 11-4a of the general 115
	160	+	statutes, containing an evaluation of the operation and effectiveness of 116
	161	+	the pilot program to the joint standing committee of the General 117
	162	+	Assembly having cognizance of matters relating to public health. 118
	163	+	Sec. 4. (NEW) (Effective July 1, 2021) (a) For the fiscal year ending June 119
	164	+	30, 2021, and each fiscal year thereafter, the Office of Higher Education 120
	165	+	shall, within available appropriations, administer a mental health care 121
	166	+	provider loan reimbursement grant program for persons who meet the 122
	167	+	eligibility requirements described in subsection (b) of this section. 123
	168	+	(b) The program shall provide student loan reimbursement grants to 124
	169	+	any person who (1) is a psychiatrist licensed pursuant to chapter 370 of 125
	170	+	the general statutes, a psychologist licensed pursuant to chapter 383 of 126
	171	+	the general statutes or an advanced practice registered nurse licensed 127
	172	+	pursuant to chapter 378 of the general statutes who is board certified as 128
	173	+	a psychiatric mental health provider by the American Nurses 129
	174	+	Credentialing Center, and (2) is employed as a mental health care 130
	175	+	provider by a federally-qualified health center in the state for not less 131
	176	+	than two years. 132
	177	+	(c) Any person who satisfies the eligibility requirements prescribed 133
	178	+	in subsection (b) of this section may receive an annual grant for 134
	179	+	reimbursement of federal or state educational loans (1) in an amount not 135
	180	+	to exceed twenty-five thousand dollars in any year, and (2) for a period 136
	181	+	not to exceed two years. Such person shall only be reimbursed for loan 137
	182	+	payments made while such person is employed by a federally-qualified 138
	183	+	health center. 139
	184	+	(d) Persons may apply to the Office of Higher Education for grants 140
	185	+	under this section at such time and in such manner as the executive 141
	186	+	director of the Office of Higher Education prescribes. 142
	187	+	(e) Any unexpended funds appropriated for purposes of this section 143
	188	+	shall not lapse at the end of the fiscal year but shall be available for 144 Raised Bill No. 1087
	189	+
	190	+
	191	+
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	193	+
	194	+	expenditure during the next fiscal year. 145
	195	+	(f) The Office of Higher Education may accept gifts, grants and 146
	196	+	donations, from any source, public or private, for the mental health care 147
	197	+	provider loan reimbursement grant program. 148
133	198		This act shall take effect as follows and shall amend the following
134	199		sections:
135	200
136	201		Section 1 July 1, 2021 19a-7d
137		-	Sec. 2 from passage New section
138		-	Sec. 3 July 1, 2021 New section
	202	+	Sec. 2 July 1, 2021 20-14p
	203	+	Sec. 3 from passage New section
	204	+	Sec. 4 July 1, 2021 New section
139	205
140		-
141		-	Statement of Legislative Commissioners:
142		-	Section 1(a), the first two references to "and registered nurses" were
143		-	bracketed for consistency with the defined term in said section.
144		-
145		-	PH Joint Favorable Subst.
	206	+	Statement of Purpose:
	207	+	To recruit and retain health care professionals in the state.
	208	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	209	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	210	+	underlined.]
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