LCO No. 6017 1 of 56
General Assembly Committee Bill No. 9
January Session, 2023
LCO No. 6017
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING HEALTH AND WELLNESS FOR
CONNECTICUT RESIDENTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective from passage) (a) As used in this section, 1
"assisted reproductive technology" has the same meaning as provided 2
in 42 USC 263a-7, as amended from time to time. 3
(b) No person or entity may prohibit or unreasonably limit any 4
person from (1) accessing assisted reproductive technology, (2) 5
continuing or completing an ongoing assisted reproductive technology 6
treatment or procedure pursuant to a written plan or agreement with a 7
health care provider, or (3) retaining all rights regarding the use of 8
reproductive genetic materials, including, but not limited to, gametes 9
and embryos. 10
(c) No person or entity may prohibit or unreasonably limit a health 11
care provider who is licensed, certified or otherwise authorized to 12
perform assisted reproductive technology treatments or procedures 13
from (1) performing any such treatment or procedure, or (2) providing 14
evidence-based information related to assisted reproductive 15
Committee Bill No. 9
LCO No. 6017 2 of 56
technology. 16
Sec. 2. (Effective July 1, 2023) The Commissioner of Social Services 17
shall adjust Medicaid reimbursement criteria to provide funding for 18
same-day access to long-acting reversible contraceptives at federally 19
qualified health centers. As used in this section, "long-acting reversible 20
contraceptive" means any method of contraception that does not have 21
to be used or applied more than once a menstrual cycle or once a 22
month. 23
Sec. 3. (NEW) (Effective October 1, 2023) (a) As used in this section: 24
(1) "Facility" means a hospital, clinic, physician's office or other 25
facility that provides reproductive health services, including the 26
building or structure in which the hospital, clinic, office or facility is 27
located; 28
(2) "Interfere with" means to restrict a person's freedom of 29
movement; 30
(3) "Intimidate" means to place a person in reasonable apprehension 31
of bodily harm to such person or to another person; 32
(4) "Physical obstruction" means rendering impassable ingress to or 33
egress from a facility that provides reproductive health services or 34
rendering passage to or from such facility unreasonably difficult or 35
hazardous; and 36
(5) "Reproductive health services" means medical, surgical, 37
counseling or referral services relating to the human reproductive 38
system, including, but not limited to, services relating to pregnancy or 39
the termination of a pregnancy. 40
(b) Any person who (1) by force or threat of force or by physical 41
obstruction, intentionally injures, intimidates or interferes with or 42
attempts to injure, intimidate or interfere with any person because that 43
person is or has been obtaining or providing reproductive health 44
Committee Bill No. 9
LCO No. 6017 3 of 56
services, or in order to intimidate such person or any other person or 45
any class of persons from obtaining or providing such services, or (2) 46
intentionally damages or destroys or attempts to damage or destroy 47
the property of a facility because such facility provides reproductive 48
health services, shall be subject to penalties as described in subsection 49
(c) of this section and may be liable for civil remedies pursuant to 50
subsection (d) of this section. A parent or legal guardian of a minor 51
shall not be subject to any such penalties for activities described in 52
subdivision (1) of this subsection if such activities are directed 53
exclusively at such minor. 54
(c) (1) Except as provided in subdivision (2) of this subsection, a 55
violation of subsection (b) is (A) a class A misdemeanor for a first 56
offense, and (B) a class E felony for any subsequent offense. 57
(2) A violation of subsection (b) that results in a (A) person suffering 58
a physical injury, as defined in section 53a-3 of the general statutes, is a 59
class C felony, or (B) person's death is a class B felony. 60
(d) (1) Any person aggrieved by reason of the conduct prohibited by 61
subsection (b) of this section may bring a civil action for the relief set 62
forth in subdivision (2) of this subsection, except such an action may be 63
brought under subdivision (1) of subsection (b) of this section only by 64
a person involved in providing or seeking to provide, or obtaining or 65
seeking to obtain, services in a facility that provides reproductive 66
health services. 67
(2) In any action under subdivision (1) of this subsection, the court 68
may award appropriate relief, including temporary, preliminary or 69
permanent injunctive relief and compensatory and punitive damages, 70
plus reasonable attorneys' fees and costs. With respect to 71
compensatory damages, the plaintiff may elect, at any time prior to the 72
rendering of final judgment, to recover, in lieu of actual damages, an 73
award of statutory damages in the amount of five thousand dollars per 74
violation. 75
Committee Bill No. 9
LCO No. 6017 4 of 56
(e) (1) If the Attorney General has reasonable cause to believe that 76
any person has been or may be injured by conduct constituting a 77
violation of subsection (b) of this section, the Attorney General may 78
bring a civil action in the Superior Court. 79
(2) In any action brought under subdivision (1) of this subsection, 80
the court may award appropriate relief, including temporary, 81
preliminary or permanent injunctive relief, and compensatory 82
damages to persons aggrieved as described in subdivision (2) of 83
subsection (c) of this section. The court, to vindicate the public interest, 84
may also assess a civil penalty against each respondent (A) in an 85
amount not exceeding ten thousand dollars for a nonviolent physical 86
obstruction and fifteen thousand dollars for other first violations, and 87
(B) in an amount not exceeding fifteen thousand dollars for a 88
nonviolent physical obstruction and twenty-five thousand dollars for 89
any other subsequent violation. 90
(f) Nothing in this section shall be construed to (1) prohibit any 91
expressive conduct, including, but not limited to, peaceful picketing or 92
other peaceful demonstration to the extent protected by article first of 93
the Constitution of the state or the first amendment to the United 94
States Constitution; (2) create any new remedies for interference with 95
activities protected by article first of the Constitution of the state or the 96
first amendment to the United States Constitution occurring outside a 97
facility, regardless of the point of view expressed, or to limit any 98
existing legal remedies for such interference; (3) provide exclusive 99
criminal penalties or civil remedies with respect to the conduct 100
prohibited by this section; or (4) interfere with the enforcement of any 101
general statute, regulation of Connecticut state agencies, local 102
ordinance or other local law concerning the provision of reproductive 103
health services. 104
Sec. 4. (Effective from passage) (a) As used in this section and section 5 105
of this act, "harm reduction center" means a medical facility where a 106
person may safely consume controlled substances under the 107
Committee Bill No. 9
LCO No. 6017 5 of 56
observation of licensed health care providers who are present to 108
provide necessary medical treatment in the event of an overdose of a 109
controlled substance. 110
(b) The Department of Mental Health and Addiction Services, in 111
consultation with the Department of Public Health, shall establish a 112
pilot program to prevent drug overdoses through the establishment of 113
harm reduction centers in three municipalities in the state selected by 114
the Commissioner of Mental Health and Addiction Services, subject to 115
the approval of the chief elected officials of each municipality selected 116
by said commissioner. 117
(c) Each harm reduction center established pursuant to subsection 118
(b) of this section shall (1) employ licensed health care providers with 119
experience treating persons with substance use disorders to monitor 120
persons utilizing the harm reduction center for the purpose of 121
providing medical treatment to any person who experiences 122
symptoms of an overdose, in a number determined sufficient by the 123
Commissioner of Mental Health and Addiction Services, and (2) 124
provide referrals for substance use disorder counseling or other mental 125
health or medical treatment services that may be appropriate for 126
persons utilizing the harm reduction center. A licensed health care 127
provider's participation in the pilot program shall not be grounds for 128
disciplinary action by the Department of Public Health pursuant to 129
section 19a-17 of the general statutes. 130
(d) The Commissioner of Mental Health and Addiction Services 131
may request a disbursement of funds from the Opioid Settlement Fund 132
established pursuant to section 17a-674a of the general statutes to fund, 133
in whole or in part, the establishment and administration of the pilot 134
program. 135
(e) The Commissioner of Mental Health and Addiction Services 136
shall adopt regulations, in accordance with the provisions of chapter 137
54 of the general statutes, to implement the provisions of this section. 138
Committee Bill No. 9
LCO No. 6017 6 of 56
Sec. 5. (Effective from passage) (a) There is established a Harm 139
Reduction Center Pilot Program Advisory Committee that shall advise 140
the Department of Mental Health and Addiction Services on issues 141
concerning the establishment of the harm reduction center pilot 142
program pursuant to section 4 of this act. The advisory committee shall 143
meet at the discretion of the Commissioner of Mental Health and 144
Addiction Services and shall make recommendations to the 145
commissioner regarding the following: 146
(1) Maximizing the potential public health and safety benefits of the 147
harm reduction centers; 148
(2) The proper disposal of hypodermic needles and syringes; 149
(3) The recovery of persons utilizing the harm reduction centers; 150
(4) Federal, state and local laws impacting the creation and 151
operation of the harm reduction centers; 152
(5) Appropriate guidance to relevant professional licensing boards 153
concerning the impact of health care providers participating in the 154
harm reduction center pilot program on the effectiveness of the pilot 155
program; 156
(6) Potential integration of the harm reduction center pilot program 157
with other public health efforts; 158
(7) Consideration of any other factors beneficial to promoting the 159
public health and safety in the operation of the harm reduction center 160
pilot program; and 161
(8) Liability protection for property owners and staff, volunteers 162
and participants in the harm reduction center pilot program, from 163
criminal or civil liability resulting from the operation of a harm 164
reduction center. 165
(b) The advisory committee shall consist of the following members: 166
Committee Bill No. 9
LCO No. 6017 7 of 56
(1) The Commissioners of Mental Health and Addiction Services 167
and Public Health, or the commissioners' designee; 168
(2) The president of the Connecticut Conference of Municipalities, 169
or the president's designee; 170
(3) The co-chairperson of the Opioid Settlement Advisory 171
Committee appointed by the speaker of the House of Representatives 172
and the president pro tempore of the Senate pursuant to subsection (c) 173
of section 17a-674d of the general statutes, or the co-chairperson's 174
designee; 175
(4) One member who represents and shall be appointed by a 176
medical society in the state; 177
(5) One member who represents and shall be appointed by a 178
hospital society in the state; 179
(6) One member who represents and shall be appointed by the 180
Connecticut chapter of a national society of addiction medicine; 181
(7) Two members appointed by the speaker of the House of 182
Representatives, one of whom shall be a person with a substance use 183
disorder, and one of whom shall be an administrator of a harm 184
reduction center operating in another state; 185
(8) Two members appointed by the president pro tempore of the 186
Senate, one of whom shall be a health care provider experienced in 187
treating persons with substance use disorders and overdose 188
prevention, and one of whom shall be an administrator of a harm 189
reduction center operating in another state; 190
(9) One member appointed by the majority leader of the House of 191
Representatives, who shall be a current or former law enforcement 192
official; 193
(10) One member appointed by the majority leader of the Senate, 194
Committee Bill No. 9
LCO No. 6017 8 of 56
who shall be a family member of a person who suffered a fatal drug 195
overdose; 196
(11) One member appointed by the minority leader of the House of 197
Representatives, who shall be a licensed mental health care provider 198
with experience treating persons with opioid use disorder; and 199
(12) One member appointed by the minority leader of the Senate, 200
who shall be a licensed health care provider with experience treating 201
persons who have experienced a drug overdose. 202
(c) The Commissioner of Mental Health and Addiction Services, or 203
said commissioner's designee, shall be the chairperson of the 204
committee. The chairperson of the committee, with a vote of the 205
majority of the members present, may appoint ex-officio nonvoting 206
members in specialties not represented among voting members. Any 207
vacancy shall be filled by the appointing authority. 208
(d) The chairperson of the advisory committee may designate one or 209
more working groups to address specific issues and shall appoint the 210
members of each working group. Each working group shall report its 211
findings and recommendations to the full advisory committee. 212
(e) Not later than January 1, 2024, and annually thereafter until the 213
termination of the pilot program, the Commissioner of Mental Health 214
and Addiction Services shall report, in accordance with the provisions 215
of section 11-4a of the general statutes, to the joint standing committee 216
of the General Assembly having cognizance of matters relating to 217
public health regarding the recommendations of the advisory 218
committee and the outcome of the harm reduction center pilot 219
program established pursuant to section 4 of this act. 220
Sec. 6. (NEW) (Effective October 1, 2023) (a) As used in this section, 221
(1) "eligible entity" means a (A) municipality, (B) local or regional 222
board of education, (C) similar body governing one or more nonpublic 223
school, (D) district department of health, (E) municipal health 224
Committee Bill No. 9
LCO No. 6017 9 of 56
department, or (F) law enforcement agency, and (2) "opioid antagonist" 225
means naloxone hydrochloride or any other similarly acting and 226
equally safe drug approved by the federal Food and Drug 227
Administration for the treatment of a drug overdose. 228
(b) There is established an Opioid Antagonist Bulk Purchase Fund 229
which shall be a separate nonlapsing account within the General Fund. 230
The account shall contain any (1) amounts appropriated or otherwise 231
made available by the state for the purposes of this section, (2) moneys 232
required by law to be deposited in the account, and (3) gifts, grants, 233
donations or bequests made for the purposes of this section. 234
Investment earnings credited to the assets of the account shall become 235
part of the assets of the account. Any balance remaining in the account 236
at the end of any fiscal year shall be carried forward in the account for 237
the fiscal year next succeeding. The State Treasurer shall administer 238
the account. All moneys deposited in the account shall be used by the 239
Department of Mental Health and Addiction Services for the purposes 240
of this section. The department may deduct and retain from the 241
moneys in the account an amount equal to the costs incurred by the 242
department in administering the provisions of this section, except that 243
said amount shall not exceed two per cent of the moneys deposited in 244
the account in any fiscal year. 245
(c) The Department of Mental Health and Addiction Services shall 246
use the Opioid Antagonist Bulk Purchase Fund to make grants to 247
eligible entities for the purchase of large quantities of opioid 248
antagonists in bulk at a discounted price. The department may contract 249
with a wholesaler of prescription drugs for the purchasing and 250
distribution of opioid antagonists in bulk. The Commissioner of 251
Mental Health and Addiction Services shall establish an application 252
process for eligible entities to apply for a grant under this subsection. 253
(d) The Department of Mental Health and Addiction Services shall 254
adopt regulations implementing the provisions of this section, in 255
accordance with the provisions of chapter 54 of the general statutes. 256
Committee Bill No. 9
LCO No. 6017 10 of 56
The department may implement the policies and procedures contained 257
in such proposed regulations while in the process of adopting such 258
proposed regulations, provided the department publishes notice of 259
intention to adopt the regulations on the department's Internet web 260
site and on the eRegulations System not later than twenty days after 261
implementing such policies and procedures. Policies and procedures 262
implemented pursuant to this subsection shall be valid until the earlier 263
of the date on which such regulations are effective or one year after the 264
publication of such notice of intention. 265
(e) Not later than January 1, 2025, and annually thereafter, the 266
Commissioner of Mental Health and Addiction Services shall report, in 267
accordance with the provision of section 11-4a of the general statutes, 268
to the joint standing committees of the General Assembly having 269
cognizance of matters relating to public health and appropriations and 270
the budgets of state agencies regarding the following information for 271
the preceding calendar year: (1) The number of grants applications 272
received, (2) the number of eligible entities that received grants under 273
this section, (3) the amount in grants made to each such eligible entity, 274
(4) the amount of opioid antagonists purchased by each such eligible 275
entity, (5) the use of the opioid antagonists purchased with such grants 276
by each such eligible entity, if known by the commissioner, and (6) any 277
recommendations regarding the Opioid Antagonist Bulk Purchase 278
Fund, including any proposed legislation to facilitate the purposes of 279
this section. 280
Sec. 7. Section 20-14o of the general statutes is repealed and the 281
following is substituted in lieu thereof (Effective October 1, 2023): 282
(a) As used in this section: 283
(1) "Opioid drug" has the same meaning as provided in 42 CFR 8.2, 284
as amended from time to time; 285
(2) "Adult" means a person who is at least eighteen years of age; 286
Committee Bill No. 9
LCO No. 6017 11 of 56
(3) "Prescribing practitioner" has the same meaning as provided in 287
section 20-14c; 288
(4) "Minor" means a person who is under eighteen years of age; 289
(5) "Opioid agonist" means a medication that binds to the opiate 290
receptors and provides relief to individuals in treatment for abuse of or 291
dependence on an opioid drug; 292
(6) "Opiate receptor" means a specific site on a cell surface that 293
interacts in a highly selective fashion with an opioid drug; 294
(7) "Palliative care" means specialized medical care to improve the 295
quality of life of patients and their families facing the problems 296
associated with a life-threatening illness; and 297
(8) "Opioid antagonist" has the same meaning as provided in section 298
17a-714a. 299
(b) When issuing a prescription for an opioid drug to an adult 300
patient for the first time for outpatient use, a prescribing practitioner 301
who is authorized to prescribe an opioid drug shall not issue a 302
prescription for more than a seven-day supply of such drug, as 303
recommended in the National Centers for Disease Control and 304
Prevention's Guideline for Prescribing Opioids for Chronic Pain. 305
(c) A prescribing practitioner shall not issue a prescription for an 306
opioid drug to a minor for more than a five-day supply of such drug. 307
(d) Notwithstanding the provisions of subsections (b) and (c) of this 308
section, if, in the professional medical judgment of a prescribing 309
practitioner, more than a seven-day supply of an opioid drug is 310
required to treat an adult patient's acute medical condition, or more 311
than a five-day supply of an opioid drug is required to treat a minor 312
patient's acute medical condition, as determined by the prescribing 313
practitioner, or is necessary for the treatment of chronic pain, pain 314
associated with a cancer diagnosis or for palliative care, then the 315
Committee Bill No. 9
LCO No. 6017 12 of 56
prescribing practitioner may issue a prescription for the quantity 316
needed to treat the acute medical condition, chronic pain, pain 317
associated with a cancer diagnosis or pain experienced while the 318
patient is in palliative care. The condition triggering the prescription of 319
an opioid drug for more than a seven-day supply for an adult patient 320
or more than a five-day supply for a minor patient shall be 321
documented in the patient's medical record and the practitioner shall 322
indicate that an alternative to the opioid drug was not appropriate to 323
address the medical condition. 324
(e) The provisions of subsections (b), (c) and (d) of this section shall 325
not apply to medications designed for the treatment of abuse of or 326
dependence on an opioid drug, including, but not limited to, opioid 327
agonists and opioid antagonists. 328
(f) When issuing a prescription for an opioid drug to an adult or 329
minor patient, the prescribing practitioner shall discuss with the 330
patient the risks associated with the use of such opioid drug, 331
including, but not limited to, the risks of addiction and overdose 332
associated with opioid drugs and the dangers of taking opioid drugs 333
with alcohol, benzodiazepines and other central nervous system 334
depressants, and the reasons the prescription is necessary, and, if 335
applicable, with the custodial parent, guardian or other person having 336
legal custody of the minor if such parent, guardian or other person is 337
present at the time of issuance of the prescription. 338
(g) When issuing a prescription for an opioid drug to an adult or 339
minor patient, the prescribing practitioner shall also issue a 340
prescription for an opioid antagonist to the patient when the following 341
risk factors are present: (1) The patient has a history of a substance use 342
disorder; (2) the prescribing practitioner issued a prescription for a 343
high-dose opioid drug that results in ninety morphine milligram 344
equivalents or higher per day; or (3) concurrent use by the patient of 345
an opioid drug and a benzodiazepine or nonbenzodiazepine sedative 346
hypnotic. 347
Committee Bill No. 9
LCO No. 6017 13 of 56
Sec. 8. (NEW) (Effective July 1, 2023) (a) As used in this section: 348
(1) "Emergency medical services personnel" has the same meaning 349
as provided in section 19a-175 of the general statutes; 350
(2) "Opioid antagonist" means naloxone hydrochloride or any other 351
similarly acting and equally safe drug approved by the federal Food 352
and Drug Administration for the treatment of a drug overdose; 353
(3) "Opioid use disorder" means a medical condition characterized 354
by a problematic pattern of opioid use and misuse leading to clinically 355
significant impairment or distress; 356
(4) "Opioid drug" has the same meaning as provided in 42 CFR 8.2, 357
as amended from time to time; and 358
(5) "Pharmacist" has the same meaning as provided in section 20-359
609a of the general statutes. 360
(b) Not later than January 1, 2024, the Office of Emergency Medical 361
Services, in collaboration with the Departments of Mental Health and 362
Addiction Services and Consumer Protection, shall develop a program 363
for the provision of opioid antagonists and related information by 364
emergency medical services personnel to certain members of the 365
public. Emergency medical services personnel shall distribute an 366
opioid antagonist kit containing a personal supply of opioid 367
antagonists and the one-page fact sheet developed by the Connecticut 368
Alcohol and Drug Policy Council pursuant to section 17a-667a of the 369
general statutes regarding the risks of taking an opioid drug, 370
symptoms of opioid use disorder and services available in the state for 371
persons who experience symptoms of or are otherwise affected by 372
opioid use disorder to a patient who (1) is treated by such personnel 373
for an overdose of an opioid drug, (2) displays symptoms to such 374
personnel of opioid use disorder, or (3) is treated at a location where 375
such personnel observes evidence of illicit use of an opioid drug, or to 376
such patient's family member, caregiver or friend who is present at the 377
Committee Bill No. 9
LCO No. 6017 14 of 56
location. Emergency medical services personnel shall refer the patient 378
or such patient's family member, caregiver or friend to the written 379
instructions regarding the administration of such opioid antagonist, as 380
deemed appropriate by such personnel. 381
(c) Emergency medical services organizations may obtain opioid 382
antagonists for dissemination through the program developed 383
pursuant to subsection (a) of this section from a pharmacist pursuant 384
to section 20-633c, 20-633d, as amended by this act, or 21a-286 of the 385
general statutes. 386
(d) Emergency medical services personnel shall document the 387
number of opioid antagonist kits distributed pursuant to subsection (a) 388
of this section, including, but not limited to, the number of doses of an 389
opioid antagonist included in each kit. 390
(e) Not later than January 1, 2025, and annually thereafter, the 391
executive director of the Office of Emergency Medical Services shall 392
report, in accordance with section 11-4a of the general statutes, to the 393
joint standing committee of the General Assembly having cognizance 394
of matters relating to public health regarding the implementation of 395
the program developed pursuant to subsection (a) of this section, 396
including, but not limited to, information contained in the 397
documentation prepared pursuant to subsection (d) of this section. 398
(f) The Department of Public Health may adopt regulations, in 399
accordance with the provisions of chapter 54 of the general statutes, to 400
implement the provisions of this section. 401
Sec. 9. Subsection (a) of section 20-633d of the general statutes is 402
repealed and the following is substituted in lieu thereof (Effective July 403
1, 2023): 404
(a) A prescribing practitioner, as defined in section 20-14c, who is 405
authorized to prescribe an opioid antagonist, as defined in section 17a-406
714a, and a pharmacy may enter into an agreement for a medical 407
Committee Bill No. 9
LCO No. 6017 15 of 56
protocol standing order at such pharmacy allowing a pharmacist 408
licensed under part II of this chapter to dispense an opioid antagonist 409
that is [(1)] administered by an intranasal application delivery system 410
or an auto-injection delivery system [, (2)] and approved by the federal 411
Food and Drug Administration [, and (3) dispensed to ] to (1) any 412
person at risk of experiencing an overdose of an opioid drug, as 413
defined in 42 CFR 8.2, [or to] (2) a family member, friend or other 414
person in a position to assist a person at risk of experiencing an 415
overdose of an opioid drug, or (3) an emergency medical services 416
organization for purposes of section 8 of this act. 417
Sec. 10. (NEW) (Effective July 1, 2023) (a) The Commissioner of 418
Education shall establish a Health Care Career Advisory Council 419
consisting of the following members: 420
(1) A representative of an association of hospitals in the state; 421
(2) A representative of a medical society in the state; 422
(3) A representative of the Connecticut chapter of a national 423
association of nurse practitioners; 424
(4) A representative of an association of nurses in the state; 425
(5) A representative of an association of physician assistants in the 426
state; 427
(6) A representative of the Connecticut chapter of a national 428
association of social workers; 429
(7) A representative of the Connecticut chapter of a national 430
association of psychologists in the state; and 431
(8) A representative of an association of pharmacists in the state. 432
(b) The advisory council shall advise the Commissioner of 433
Education concerning the development of a health care career program 434
consisting of (1) the promotion of the health care professions as career 435
Committee Bill No. 9
LCO No. 6017 16 of 56
options to students in middle and high school, including, but not 436
limited to, through career day presentations regarding health care 437
career opportunities in the state, the development of partnerships with 438
health care career education programs in the state and the creation of 439
counseling programs directed to high school students in order to 440
inform them about and recruit them to the health care professions, and 441
(2) job shadowing and internship experiences in health care fields for 442
high school students. 443
(c) Members shall receive no compensation except for 444
reimbursement for necessary expenses incurred in performing their 445
duties. 446
(d) The Commissioner of Education shall schedule the first meeting 447
of the advisory council, which shall be held not later than September 1, 448
2023. The members shall elect the chairperson of the advisory council 449
from among the members of the council. A majority of the council 450
members shall constitute a quorum. A majority vote of a quorum shall 451
be required for any official action of the advisory council. The advisory 452
council shall meet upon the call of the chairperson or upon the 453
majority request of the council members. 454
(e) Not later than January 1, 2024, and not less than annually 455
thereafter, the advisory council shall submit a report, in accordance 456
with the provisions of section 11-4a of the general statutes, on its 457
recommendations to the Commissioner of Education and to the joint 458
standing committees of the General Assembly having cognizance of 459
matters relating to education and public health. 460
(f) The Commissioner of Education shall notify each local and 461
regional board of education of the advisory council's recommendations 462
not later than thirty days after the commissioner's receipt of the 463
advisory council's report containing such recommendations. 464
Sec. 11. (Effective from passage) (a) The Commissioner of Public 465
Health shall convene a working group to develop recommendations 466
Committee Bill No. 9
LCO No. 6017 17 of 56
for expanding the nursing workforce in the state. The working group 467
shall evaluate the following: (1) The quality of the nursing and nurse's 468
aides education programs in the state; (2) the quality of the clinical 469
training programs for nurses and nurse's aides in the state; (3) the 470
potential for increasing the number of clinical training sites for nurses 471
and nurse's aides; (4) the expansion of clinical training facilities in the 472
state for nurses and nurse's aides; and (5) barriers to recruitment and 473
retention of nurses and nurse's aides. 474
(b) The working group shall consist of the following members: 475
(1) Two representatives of a labor organization representing acute 476
care hospital workers in the state; 477
(2) Two representatives of a labor organization representing nurses 478
and nurse's aides employed by the state of Connecticut or a hospital or 479
long-term care facility in the state; 480
(3) Two representatives of a labor organization representing faculty 481
and professional staff at the regional community-technical colleges; 482
(4) The president of the Board of Regents for Higher Education, or 483
the president's designee; 484
(5) The president of the Connecticut State Colleges and Universities, 485
or the president's designee; 486
(6) The president of The University of Connecticut, or the 487
president's designee; 488
(7) One member of the administration of The University of 489
Connecticut Health Center; 490
(8) Two representatives of the Connecticut Conference of 491
Independent Colleges; 492
(9) The Commissioner of Public Health, or the commissioner's 493
designee; 494
Committee Bill No. 9
LCO No. 6017 18 of 56
(10) The Commissioner of Social Services, or the commissioner's 495
designee; 496
(11) The Commissioner of Administrative Services, or the 497
commissioner's designee; 498
(12) The Secretary of the Office of Policy and Management, or the 499
secretary's designee; 500
(13) A representative of the State Board of Examiners for Nursing; 501
(14) The chairpersons and ranking members of the joint standing 502
committee of the General Assembly having cognizance of matters 503
relating to public health, or the chairpersons' designees; and 504
(15) The chairpersons and ranking members of the joint standing 505
committee of the General Assembly having cognizance of matters 506
relating to higher education and employment advancement, or the 507
chairpersons' designees. 508
(c) The cochairpersons of the working group shall be the 509
Commissioner of Public Health, or the commissioner's designee, and 510
the president of the Board of Regents for Higher Education, or the 511
president's designee. The cochairpersons shall schedule the first 512
meeting of the working group, which shall be held not later than sixty 513
days after the effective date of this section. 514
(d) Not later than January 1, 2024, the working group shall submit a 515
report, in accordance with section 11-4a of the general statutes, to the 516
joint standing committees of the General Assembly having cognizance 517
of matters relating to public health and higher education and 518
employment advancement on its findings and any recommendations 519
for improving the recruitment and retention of nurses and nurse's 520
aides in the state, including, but not limited to, a five-year plan and a 521
ten-year plan for increasing the nursing workforce in the state. The 522
working group shall terminate on the date that it submits such report 523
or January 1, 2024, whichever is later. 524
Committee Bill No. 9
LCO No. 6017 19 of 56
Sec. 12. (NEW) (Effective July 1, 2023) On and after January 1, 2024, 525
notwithstanding any provision of title 10a of the general statutes, each 526
public institution of higher education shall consider any licensed 527
health care provider who (1) has not less than ten years of clinical 528
health care experience in a field in which such provider is licensed, 529
and (2) applies for a position as an adjunct faculty member at such 530
institution of higher education in a health care related field in which 531
such provider has such experience, to be a qualified applicant for such 532
position and give such provider the same consideration as any other 533
qualified applicant for such position. As used in this section, "public 534
institution of higher education" means those constituent units 535
identified in subdivisions (2) and (3) of section 10a-1 of the general 536
statutes. 537
Sec. 13. (NEW) (Effective July 1, 2023) (a) On or before January 1, 538
2024, the Office of Higher Education shall establish and administer an 539
adjunct professor incentive grant program. The program shall provide 540
incentive grants to each licensed health care provider who accepts a 541
position as an adjunct professor at a public institution of higher 542
education that was offered to such provider after being considered as 543
an applicant for such position pursuant to section 12 of this act. Such 544
grants shall be in an annual amount that represents the difference 545
between the provider's most recent annual salary as a licensed health 546
care provider in the clinical setting and the provider's salary as an 547
adjunct professor at such institution of higher education, for as long as 548
such provider remains employed as an adjunct professor in a health 549
care related field at such institution of higher education. The executive 550
director of the Office of Higher Education shall establish the 551
application process for the grant program. 552
(b) Not later than January 1, 2025, and annually thereafter, the 553
executive director of the Office of Higher Education shall report, in 554
accordance with the provisions of section 11-4a of the general statutes, 555
to the joint standing committee of the General Assembly having 556
cognizance of matters relating to public health regarding the number 557
Committee Bill No. 9
LCO No. 6017 20 of 56
and demographics of the adjunct professors who applied for and 558
received incentive grants from the adjunct professor grant program 559
established under subsection (a) of this section, the number and types 560
of classes taught by such adjunct professors, the institutions of higher 561
education employing such adjunct professors and any other 562
information deemed pertinent by the executive director. 563
Sec. 14. (NEW) (Effective July 1, 2023) On and after January 1, 2024, 564
the Department of Public Health shall offer any competency 565
evaluations prescribed by the Commissioner of Public Health for 566
nurse's aides, as defined in section 20-102aa of the general statutes, in 567
both English and Spanish. 568
Sec. 15. (NEW) (Effective July 1, 2023) (a) As used in this section, 569
"personal care attendant", "consumer" and "personal care assistance" 570
have the same meanings as provided in section 17b-706 of the general 571
statutes. 572
(b) Not later than January 1, 2024, the Department of Social Services 573
shall establish and administer a personal care attendants career 574
pathways program to improve the quality of care offered by personal 575
care attendants and incentivize the recruitment and retention of 576
personal care attendants in the state. A personal care attendant who is 577
not employed by a consumer, but who is eligible for employment by a 578
consumer, may participate in the program following the completion of 579
a program orientation developed by the Commissioner of Social 580
Services. 581
(c) The career pathways program shall include, but need not be 582
limited to, the following objectives: 583
(1) Increase in employment retention and recruitment of personal 584
care attendants to maintain a stable workforce for consumers, 585
including, but not limited to, through the creation of career pathways 586
for such attendants that improve skill and knowledge and increase 587
wages; 588
Committee Bill No. 9
LCO No. 6017 21 of 56
(2) Dignity in providing and receiving care through meaningful 589
collaboration between consumers and personal care attendants; 590
(3) Improvement in the quality of personal care assistance and the 591
overall quality of life of the consumer; 592
(4) Advancement of equity in the provision of personal care 593
assistance; 594
(5) Promotion of a culturally and linguistically competent workforce 595
of personal attendants to serve the growing racial, ethnic and linguistic 596
diversity of an aging population of consumers; and 597
(6) Promotion of self-determination principles by personal care 598
attendants. 599
(d) The Commissioner of Social Services shall offer the following 600
career pathways as part of the career pathways program: 601
(1) The basic skills career pathways, including (A) general health 602
and safety, and (B) adult education topics; and 603
(2) The specialized skills career pathways, including (A) cognitive 604
impairments and behavioral health, (B) complex physical care needs, 605
and (C) transitioning to home and community-based living from out-606
of-home care or homelessness. 607
(e) The Commissioner of Social Services shall develop or identify, in 608
consultation with a labor management committee at a hospital or 609
health care organization, the training curriculum for each career 610
pathway of the career pathways program. 611
(f) Not later than January 1, 2025, the Commissioner of Social 612
Services shall report in accordance with the provisions of section 11-4a 613
of the general statutes, to the joint standing committees of the General 614
Assembly having cognizance of matters relating to human services and 615
public health, on the following information concerning the career 616
Committee Bill No. 9
LCO No. 6017 22 of 56
pathways program: 617
(1) The number of personal care attendants who enrolled in the 618
program and types of career pathways chosen by each attendant; 619
(2) The number of personal care attendants who successfully 620
completed a career pathway and the types of career pathways 621
completed by each attendant; 622
(3) The effectiveness of the program, as determined by surveys, 623
focus groups and interviews of personal care attendants, and whether 624
the successful completion of a career pathway resulted in a related 625
license or certificate for each personal care attendant or the retention of 626
employment as a personal care attendant; 627
(4) The number of personal care attendants who were employed by 628
a consumer with specialized care needs after completing a specialized 629
career pathway and who were retained in employment by such 630
consumer for a period of not less than six months; and 631
(5) The number of personal care attendants who were employed by 632
a consumer with specialized care needs after completing a specialized 633
career pathway and were retained in employment by such consumer 634
for a period of at least twelve months. 635
Sec. 16. (NEW) (Effective October 1, 2023) No hospital, or medical 636
review committee of a hospital, shall require, as part of its 637
credentialing requirements for a physician to be granted privileges to 638
practice in the hospital, that a physician provide credentials of any 639
board certification in a particular specialty. 640
Sec. 17. Section 20-14p of the general statutes is repealed and the 641
following is substituted in lieu thereof (Effective July 1, 2023): 642
(a) For purposes of this section: (1) "Covenant not to compete" 643
means any provision of an employment or other contract or agreement 644
that creates or establishes a professional relationship with a physician 645
Committee Bill No. 9
LCO No. 6017 23 of 56
and restricts the right of a physician to practice medicine in any 646
geographic area of the state for any period of time after the termination 647
or cessation of such partnership, employment or other professional 648
relationship; (2) "physician" means an individual licensed to practice 649
medicine under this chapter; and (3) "primary site where such 650
physician practices" means (A) the office, facility or location where a 651
majority of the revenue derived from such physician's services is 652
generated, or (B) any other office, facility or location where such 653
physician practices and mutually agreed to by the parties and 654
identified in the covenant not to compete. 655
(b) (1) A covenant not to compete that is entered into, amended, 656
extended or renewed prior to July 1, 2023, is valid and enforceable only 657
if it is: (A) Necessary to protect a legitimate business interest; (B) 658
reasonably limited in time, geographic scope and practice restrictions 659
as necessary to protect such business interest; and (C) otherwise 660
consistent with the law and public policy. The party seeking to enforce 661
a covenant not to compete shall have the burden of proof in any 662
proceeding. 663
(2) A covenant not to compete that is entered into, amended, 664
extended or renewed on or after July 1, 2016, but before June 30, 2023, 665
shall not: (A) Restrict the physician's competitive activities (i) for a 666
period of more than one year, and (ii) in a geographic region of more 667
than fifteen miles from the primary site where such physician 668
practices; or (B) be enforceable against a physician if (i) such 669
employment contract or agreement was not made in anticipation of, or 670
as part of, a partnership or ownership agreement and such contract or 671
agreement expires and is not renewed, unless, prior to such expiration, 672
the employer makes a bona fide offer to renew the contract on the 673
same or similar terms and conditions, or (ii) the employment or 674
contractual relationship is terminated by the employer, unless such 675
employment or contractual relationship is terminated for cause. 676
(3) Each covenant not to compete entered into, amended or renewed 677
Committee Bill No. 9
LCO No. 6017 24 of 56
on and after July 1, 2016, until June 30, 2023, shall be separately and 678
individually signed by the physician. 679
(4) On and after July 1, 2023, no employment, partnership or 680
ownership contract or agreement entered into, amended or renewed 681
shall contain a covenant not to compete and each covenant not to 682
compete entered into, amended or renewed on and after said date shall 683
be void and unenforceable. Any physician who is aggrieved by a 684
violation of this subdivision may bring a civil action in the Superior 685
Court to recover damages, together with court costs and reasonable 686
attorney's fees, and for such injunctive and equitable relief as the court 687
deems appropriate. 688
(c) The remaining provisions of any contract or agreement that 689
includes a covenant not to compete that is rendered void and 690
unenforceable, in whole or in part, under the provisions of this section 691
shall remain in full force and effect, including provisions that require 692
the payment of damages resulting from any injury suffered by reason 693
of termination of such contract or agreement. 694
Sec. 18. (NEW) (Effective July 1, 2023) (a) For purposes of this section: 695
(1) "Covenant not to compete" means any provision of an employment 696
or other contract or agreement that creates or establishes a professional 697
relationship with an advanced practice registered nurse and restricts 698
the right of an advanced practice registered nurse to provide health 699
care services as an advanced practice registered nurse in any 700
geographic area of the state for any period of time after the termination 701
or cessation of such partnership, employment or other professional 702
relationship; and (2) "advanced practice registered nurse" means an 703
individual licensed as an advanced practice registered nurse pursuant 704
to chapter 378 of the general statutes. 705
(b) On and after July 1, 2023, no employment, partnership or 706
ownership contract or agreement entered into, amended or renewed 707
shall contain a covenant not to compete and each covenant not to 708
compete entered into, amended or renewed on and after said date shall 709
Committee Bill No. 9
LCO No. 6017 25 of 56
be void and unenforceable. Any advanced practice registered nurse 710
who is aggrieved by a violation of this subsection may bring a civil 711
action in the Superior Court to recover damages, together with court 712
costs and reasonable attorney's fees, and for such injunctive and 713
equitable relief as the court deems appropriate. 714
(c) The remaining provisions of any contract or agreement that 715
includes a covenant not to compete that is rendered void and 716
unenforceable, in whole or in part, under the provisions of this section 717
shall remain in full force and effect, including provisions that require 718
the payment of damages resulting from any injury suffered by reason 719
of termination of such contract or agreement. 720
Sec. 19. (Effective from passage) (a) There is established a task force to 721
study medical malpractice reform to incentivize physicians and other 722
licensed health care providers to practice in the state. 723
(b) The task force shall consist of the following members: 724
(1) Two appointed by the speaker of the House of Representatives, 725
one of whom has expertise in medical malpractice laws and one of 726
whom has expertise in tort reform; 727
(2) Two appointed by the president pro tempore of the Senate, one 728
of whom shall be a representative of a medical society in the state and 729
one of whom shall be a representative of a hospital association in the 730
state; 731
(3) One appointed by the majority leader of the House of 732
Representatives, who shall be a representative of a nurse's association 733
in the state; 734
(4) One appointed by the majority leader of the Senate, who shall be 735
a member of the judiciary; 736
(5) One appointed by the minority leader of the House of 737
Representatives, who shall be a member of an association of trial 738
Committee Bill No. 9
LCO No. 6017 26 of 56
lawyers in the state; 739
(6) One appointed by the minority leader of the Senate, who shall be 740
a health care advocate in the state; and 741
(7) The Commissioner of Public Health, or the commissioner's 742
designee. 743
(c) Any member of the task force appointed under subdivision (1), 744
(2), (3), (4), (5) or (6) of subsection (b) of this section may be a member 745
of the General Assembly. 746
(d) All initial appointments to the task force shall be made not later 747
than thirty days after the effective date of this section. Any vacancy 748
shall be filled by the appointing authority. 749
(e) The speaker of the House of Representatives and the president 750
pro tempore of the Senate shall select the chairpersons of the task force 751
from among the members of the task force. Such chairpersons shall 752
schedule the first meeting of the task force, which shall be held not 753
later than sixty days after the effective date of this section. 754
(f) The administrative staff of the joint standing committee of the 755
General Assembly having cognizance of matters relating to public 756
health shall serve as administrative staff of the task force. 757
(g) Not later than January 1, 2024, the task force shall submit a 758
report on its findings and recommendations to the joint standing 759
committee of the General Assembly having cognizance of matters 760
relating to public health, in accordance with the provisions of section 761
11-4a of the general statutes. The task force shall terminate on the date 762
that it submits such report or January 1, 2024, whichever is later. 763
Sec. 20. (NEW) (Effective July 1, 2023) The Physical Therapy 764
Licensure Compact is hereby enacted into law and entered into by the 765
state of Connecticut with any and all jurisdictions legally joining 766
therein in accordance with its terms. The compact is substantially as 767
Committee Bill No. 9
LCO No. 6017 27 of 56
follows: 768
"PHYSICAL THERAPY LICENSURE COMPACT 769
SECTION 1. PURPOSE 770
The purpose of the compact is to facilitate interstate practice of 771
physical therapy with the goal of improving public access to physical 772
therapy services. The practice of physical therapy occurs in the state 773
where the patient is located at the time of the patient encounter. The 774
compact preserves the regulatory authority of states to protect public 775
health and safety through the current system of state licensure. 776
The compact is designed to achieve the following objectives: 777
(1) Increase public access to physical therapy services by providing 778
for the mutual recognition of other member state licenses; 779
(2) Enhance the states' ability to protect the public's health and 780
safety; 781
(3) Encourage the cooperation of member states in regulating multi-782
state physical therapy practice; 783
(4) Support spouses of relocating military members; 784
(5) Enhance the exchange of licensure, investigative and disciplinary 785
information between member states; and 786
(6) Allow a remote state to hold a provider of services with a 787
compact privilege in such state accountable to such state's practice 788
standards. 789
SECTION 2. DEFINITION 790
As used in section 1, this section and sections 3 to 12, inclusive, of 791
the compact, and except as otherwise provided: 792
(1) "Active duty military" means full-time duty status in the active 793
Committee Bill No. 9
LCO No. 6017 28 of 56
uniformed service of the United States, including members of the 794
National Guard and Reserve on active duty orders pursuant to 10 USC 795
1209 and 1211, as amended from time to time; 796
(2) "Adverse action" means disciplinary action taken by a physical 797
therapy licensing board based upon misconduct, unacceptable 798
performance or a combination of both; 799
(3) "Alternative program" means a nondisciplinary monitoring or 800
practice remediation process approved by a physical therapy licensing 801
board, including, but not limited to, substance abuse issues; 802
(4) "Compact privilege" means the authorization granted by a 803
remote state to allow a licensee from another member state to practice 804
as a physical therapist or work as a physical therapist assistant in the 805
remote state under its laws and rules. The practice of physical therapy 806
occurs in the member state where the patient or client is located at the 807
time of the patient or client encounter; 808
(5) "Continuing competence" means a requirement, as a condition of 809
license renewal, to provide evidence of participation in, or completion 810
of, educational and professional activities relevant to practice or area 811
of work; 812
(6) "Data system" means a repository of information about licensees, 813
including examination, licensure, investigative, compact privilege and 814
adverse action; 815
(7) "Encumbered license" means a license that a physical therapy 816
licensing board has limited in any way; 817
(8) "Executive board" means a group of directors elected or 818
appointed to act on behalf of, and within the powers granted to them, 819
by the commission; 820
(9) "Home state" means the member state that is the licensee's 821
primary state of residence; 822
Committee Bill No. 9
LCO No. 6017 29 of 56
(10) "Investigative information" means information, records and 823
documents received or generated by a physical therapy licensing 824
board pursuant to an investigation; 825
(11) "Jurisprudence requirement" means the assessment of an 826
individual's knowledge of the laws and rules governing the practice of 827
physical therapy in a state; 828
(12) "Licensee" means an individual who currently holds an 829
authorization from the state to practice as a physical therapist or to 830
work as a physical therapist assistant; 831
(13) "Member state" means a state that has enacted the compact; 832
(14) "Party state" means any member state in which a licensee holds 833
a current license or compact privilege or is applying for a license or 834
compact privilege; 835
(15) "Physical therapist" means an individual who is licensed by a 836
state to practice physical therapy; 837
(16) "Physical therapist assistant" means an individual who is 838
licensed or certified by a state and who assists the physical therapist in 839
selected components of physical therapy; 840
(17) "Physical therapy", "physical therapy practice" and "the practice 841
of physical therapy" mean the care and services provided by or under 842
the direction and supervision of a licensed physical therapist; 843
(18) "Physical Therapy Compact Commission" or "commission" 844
means the national administrative body whose membership consists of 845
all states that have enacted the compact; 846
(19) "Physical therapy licensing board" or "licensing board" means 847
the agency of a state that is responsible for the licensing and regulation 848
of physical therapists and physical therapist assistants; 849
(20) "Remote state" means a member state other than the home state, 850
Committee Bill No. 9
LCO No. 6017 30 of 56
where a licensee is exercising or seeking to exercise the compact 851
privilege; 852
(21) "Rule" means a regulation, principle, or directive promulgated 853
by the commission that has the force of law; and 854
(22) "State" means any state, commonwealth, district or territory of 855
the United States of America that regulates the practice of physical 856
therapy. 857
SECTION 3. STATE PARTICIPATION IN THE COMPACT 858
(a) To participate in the compact, a state shall: 859
(1) Participate fully in the commission's data system, including 860
using the commission's unique identifier as defined in rules; 861
(2) Have a mechanism in place for receiving and investigating 862
complaints about licensees; 863
(3) Notify the commission, in compliance with the terms of the 864
compact and rules, of any adverse action or of the availability of 865
investigative information regarding a licensee; 866
(4) Fully implement a criminal background check requirement, 867
within a time frame established by rule, by receiving the results of the 868
Federal Bureau of Investigation record search on criminal background 869
checks and use the results in making licensure decisions in accordance 870
with subsection (b) of this section; 871
(5) Comply with the rules of the commission; 872
(6) Utilize a recognized national examination as a requirement for 873
licensure pursuant to the rules of the commission; and 874
(7) Have continuing competence requirements as a condition for 875
license renewal. 876
Committee Bill No. 9
LCO No. 6017 31 of 56
(b) Upon adoption of the compact, the member state shall have the 877
authority to obtain biometric-based information from each physical 878
therapy licensure applicant and shall submit such information to the 879
Federal Bureau of Investigation for a criminal background check in 880
accordance with 28 USC 534 and 42 USC 14616, as amended from time 881
to time. 882
(c) A member state shall grant the compact privilege to a licensee 883
holding a valid unencumbered license in another member state in 884
accordance with the terms of the compact and rules. 885
(d) Member states may charge a fee for granting a compact 886
privilege. 887
SECTION 4. COMPACT PRIVILEGE 888
(a) To exercise the compact privilege under the terms and 889
provisions of the compact, the licensee shall: 890
(1) Hold a license in the home state; 891
(2) Have no encumbrance on any state license; 892
(3) Be eligible for a compact privilege in any member state in 893
accordance with subsections (d), (g) and (h) of this section; 894
(4) Have not had any adverse action against any license or compact 895
privilege within the previous two years; 896
(5) Notify the commission that the licensee is seeking the compact 897
privilege within a remote state or remote states; 898
(6) Pay any applicable fees, including any state fee, for the compact 899
privilege; 900
(7) Meet any jurisprudence requirements established by the remote 901
state or states in which the licensee is seeking a compact privilege; and 902
Committee Bill No. 9
LCO No. 6017 32 of 56
(8) Report to the commission adverse action taken by any 903
nonmember state not later than thirty days after the date the adverse 904
action is taken. 905
(b) The compact privilege is valid until the expiration date of the 906
home license. The licensee shall comply with the requirements of 907
subsection (a) of this section of the compact to maintain the compact 908
privilege in the remote state. 909
(c) A licensee providing physical therapy in a remote state under the 910
compact privilege shall function within the laws and regulations of the 911
remote state. 912
(d) A licensee providing physical therapy in a remote state is subject 913
to such state's regulatory authority. A remote state may, in accordance 914
with due process and such state's laws, remove a licensee's compact 915
privilege in the remote state for a specific period of time, impose fines 916
and take any other necessary action to protect the health and safety of 917
its citizens. The licensee is not eligible for a compact privilege in any 918
state until the specific time for removal has passed and all fines are 919
paid. 920
(e) If a home state license is encumbered, the licensee shall lose the 921
compact privilege in any remote state until the following occur: 922
(1) The home state license is no longer encumbered; and 923
(2) Two years have elapsed from the date of the adverse action. 924
(f) Once an encumbered license in the home state is restored to good 925
standing, the licensee shall meet the requirements of subsection (a) of 926
this section of the compact to obtain a compact privilege in any remote 927
state. 928
(g) If a licensee's compact privilege in any remote state is removed, 929
the individual shall lose the compact privilege in any remote state until 930
the following occur: 931
Committee Bill No. 9
LCO No. 6017 33 of 56
(1) The specific period of time for which the compact privilege was 932
removed has ended; 933
(2) All fines have been paid; and 934
(3) Two years have elapsed from the date of the adverse action. 935
(h) Once the requirements of subsection (g) of this section of the 936
compact have been met, the licensee shall meet the requirements set 937
forth in subsection (a) of this section of the compact to obtain a 938
compact privilege in a remote state. 939
SECTION 5. ACTIVE DUTY MILITARY PERSONNEL OR THEIR 940
SPOUSES 941
A licensee who is active duty military or is the spouse of an 942
individual who is active duty military may designate one of the 943
following as the home state: 944
(1) Home of record; 945
(2) Permanent change of station (PCS); or 946
(3) State of current residence if such state is different from the PCS 947
state or home of record. 948
SECTION 6. ADVERSE ACTIONS 949
(a) A home state shall have exclusive power to impose adverse 950
action against a license issued by the home state. 951
(b) A home state may take adverse action based on the investigative 952
information of a remote state, so long as the home state follows its own 953
procedures for imposing adverse action. 954
(c) Nothing in the compact shall override a member state's decision 955
that participation in an alternative program may be used in lieu of 956
adverse action and that such participation shall remain nonpublic if 957
Committee Bill No. 9
LCO No. 6017 34 of 56
required by the member state's laws. Member states shall require 958
licensees who enter any alternative programs in lieu of discipline to 959
agree not to practice in any other member state during the term of the 960
alternative program without prior authorization from such other 961
member state. 962
(d) Any member state may investigate actual or alleged violations of 963
the statutes and rules authorizing the practice of physical therapy in 964
any other member state in which a physical therapist or physical 965
therapist assistant holds a license or compact privilege. 966
(e) A remote state shall have the authority to: 967
(1) Take adverse actions as set forth in subsection (d) of section 4 of 968
the compact against a licensee's compact privilege in the state; 969
(2) Issue subpoenas for both hearings and investigations that require 970
the attendance and testimony of witnesses and the production of 971
evidence. Subpoenas issued by a physical therapy licensing board in a 972
party state for the attendance and testimony of witnesses or the 973
production of evidence from another party state shall be enforced in 974
such other party state by any court of competent jurisdiction, 975
according to the practice and procedure of such court applicable to 976
subpoenas issued in proceedings pending before such court. The 977
issuing authority shall pay any witness fees, travel expenses, mileage 978
and other fees required by the service statutes of the state where the 979
witnesses or evidence are located; and 980
(3) If otherwise permitted by state law, recover from the licensee the 981
costs of investigations and disposition of cases resulting from any 982
adverse action taken against such licensee. 983
(f) Joint Investigations 984
(1) In addition to the authority granted to a member state by its 985
respective physical therapy practice act or other applicable state law, a 986
member state may participate with other member states in joint 987
Committee Bill No. 9
LCO No. 6017 35 of 56
investigations of licensees. 988
(2) Member states shall share any investigative, litigation or 989
compliance materials in furtherance of any joint or individual 990
investigation initiated under the compact. 991
SECTION 7. ESTABLISHMENT OF T HE PHYSICAL THERAPY 992
COMPACT COMMISSION 993
(a) The compact member states hereby create and establish a joint 994
public agency known as the Physical Therapy Compact Commission. 995
(1) The commission is an instrumentality of the compact states. 996
(2) Venue is proper and judicial proceedings by or against the 997
commission shall be brought solely and exclusively in a court of 998
competent jurisdiction where the principal office of the commission is 999
located. The commission may waive venue and jurisdictional defenses 1000
to the extent that it adopts or consents to participate in alternative 1001
dispute resolution proceedings. 1002
(3) Nothing in the compact shall be construed to be a waiver of 1003
sovereign immunity. 1004
(b) Membership, Voting and Meetings 1005
(1) Each member state shall have and be limited to one delegate 1006
selected by such member state's licensing board. 1007
(2) The delegate shall be a current member of the licensing board 1008
who is a physical therapist, a physical therapist assistant, a public 1009
member or the board administrator. 1010
(3) Any delegate may be removed or suspended from office as 1011
provided by the law of the state from which the delegate is appointed. 1012
(4) The member state board shall fill any vacancy occurring in the 1013
commission. 1014
Committee Bill No. 9
LCO No. 6017 36 of 56
(5) Each delegate shall be entitled to one vote with regard to the 1015
promulgation of rules and creation of bylaws and shall otherwise have 1016
an opportunity to participate in the business and affairs of the 1017
commission. 1018
(6) A delegate shall vote in person or by such other means as 1019
provided in the bylaws. The bylaws may provide for delegates' 1020
participation in meetings by telephone or other means of 1021
communication. 1022
(7) The commission shall meet at least once during each calendar 1023
year. Additional meetings shall be held as set forth in the bylaws. 1024
(c) The commission shall have the following powers and duties: 1025
(1) Establish the fiscal year of the commission; 1026
(2) Establish bylaws; 1027
(3) Maintain its financial records in accordance with the bylaws; 1028
(4) Meet and take such actions as are consistent with the provisions 1029
of the compact and the bylaws; 1030
(5) Promulgate uniform rules to facilitate and coordinate 1031
implementation and administration of the compact. The rules shall 1032
have the force and effect of law and shall be binding in all member 1033
states; 1034
(6) Bring and prosecute legal proceedings or actions in the name of 1035
the commission, provided the standing of any state physical therapy 1036
licensing board to sue or be sued under applicable law shall not be 1037
affected; 1038
(7) Purchase and maintain insurance and bonds; 1039
(8) Borrow, accept or contract for services of personnel, including, 1040
but not limited to, employees of a member state; 1041
Committee Bill No. 9
LCO No. 6017 37 of 56
(9) Hire employees, elect or appoint officers, fix compensation, 1042
define duties and grant such individuals appropriate authority to carry 1043
out the purposes of the compact and establish the commission's 1044
personnel policies and programs relating to conflicts of interest, 1045
qualifications of personnel and other related personnel matters; 1046
(10) Accept any and all appropriate donations and grants of money, 1047
equipment, supplies, materials and services and receive, utilize and 1048
dispose of such money, equipment, supplies, materials and services, 1049
provided at all times the commission shall avoid any appearance of 1050
impropriety or conflict of interest; 1051
(11) Lease, purchase, accept appropriate gifts or donations of, or 1052
otherwise own, hold, improve or use any property, real, personal or 1053
mixed, provided at all times the commission shall avoid any 1054
appearance of impropriety; 1055
(12) Sell, convey, mortgage, pledge, lease, exchange, abandon or 1056
otherwise dispose of any real, personal or mixed property; 1057
(13) Establish a budget and make expenditures; 1058
(14) Borrow money; 1059
(15) Appoint committees, including standing committees composed 1060
of members, state regulators, state legislators or their representatives, 1061
and consumer representatives and such other interested persons as 1062
may be designated in the compact and the bylaws; 1063
(16) Provide and receive information from, and cooperate with, law-1064
enforcement agencies; 1065
(17) Establish and elect an executive board; and 1066
(18) Perform such other functions as may be necessary or 1067
appropriate to achieve the purposes of the compact consistent with the 1068
state regulation of physical therapy licensure and practice. 1069
Committee Bill No. 9
LCO No. 6017 38 of 56
(d) The Executive Board 1070
The executive board shall have the power to act on behalf of the 1071
commission according to the terms of the compact. 1072
(1) The executive board shall be composed of nine members as 1073
follows: 1074
(A) Seven voting members who are elected by the commission from 1075
the current membership of the commission; 1076
(B) One ex-officio, nonvoting member from the recognized national 1077
physical therapy professional association; and 1078
(C) One ex-officio, nonvoting member from the recognized 1079
membership organization of the physical therapy licensing boards. 1080
(2) The ex-officio members shall be selected by their respective 1081
organizations. 1082
(3) The commission may remove any member of the executive 1083
board as provided in bylaws. 1084
(4) The executive board shall meet at least annually. 1085
(5) The executive board shall have the following duties and 1086
responsibilities: 1087
(A) Recommend to the entire commission changes to the rules or 1088
bylaws, changes to the compact legislation, fees paid by compact 1089
member states, including annual dues, and any commission compact 1090
fee charged to licensees for the compact privilege; 1091
(B) Ensure compact administration services are appropriately 1092
provided, contractual or otherwise; 1093
(C) Prepare and recommend the budget; 1094
(D) Maintain financial records on behalf of the commission; 1095
Committee Bill No. 9
LCO No. 6017 39 of 56
(E) Monitor compact compliance of member states and provide 1096
compliance reports to the commission; 1097
(F) Establish additional committees as necessary; and 1098
(G) Perform other duties as provided in rules or bylaws. 1099
(e) Meetings of the Commission 1100
(1) All meetings shall be open to the public, and public notice of 1101
meetings shall be given in the same manner as required under the 1102
rulemaking provisions of section 9 of the compact. 1103
(2) The commission or the executive board or other committees of 1104
the commission may convene in a closed, nonpublic meeting if the 1105
commission or executive board or other committees of the commission 1106
shall discuss: 1107
(A) Noncompliance of a member state with its obligations under the 1108
compact; 1109
(B) The employment, compensation, discipline or other matters, 1110
practices or procedures related to specific employees or other matters 1111
related to the commission's internal personnel practices and 1112
procedures; 1113
(C) Current, threatened or reasonably anticipated litigation; 1114
(D) Negotiation of contracts for the purchase, lease or sale of goods, 1115
services or real estate; 1116
(E) Accusing any person of a crime or formally censuring any 1117
person; 1118
(F) Disclosure of trade secrets or commercial or financial 1119
information that is privileged or confidential; 1120
(G) Disclosure of information of a personal nature where disclosure 1121
Committee Bill No. 9
LCO No. 6017 40 of 56
would constitute a clearly unwarranted invasion of personal privacy; 1122
(H) Disclosure of investigative records compiled for law-1123
enforcement purposes; 1124
(I) Disclosure of information related to any investigative reports 1125
prepared by or on behalf of or for use of the commission or other 1126
committee charged with responsibility of investigation or 1127
determination of compliance issues pursuant to the compact; or 1128
(J) Matters specifically exempted from disclosure by federal or 1129
member state statute. 1130
(3) If a meeting or portion of a meeting is closed pursuant to this 1131
provision, the commission's legal counsel or designee shall certify that 1132
the meeting may be closed and shall reference each relevant exempting 1133
provision. 1134
(4) The commission shall keep minutes that fully and clearly 1135
describe all matters discussed in a meeting and shall provide a full and 1136
accurate summary of actions taken and the reasons therefor, including 1137
a description of the views expressed. All documents considered in 1138
connection with an action shall be identified in such minutes. All 1139
minutes and documents of a closed meeting shall remain under seal, 1140
subject to release by a majority vote of the commission or order of a 1141
court of competent jurisdiction. 1142
(f) Financing of the Commission 1143
(1) The commission shall pay or provide for the payment of the 1144
reasonable expenses of its establishment, organization and ongoing 1145
activities. 1146
(2) The commission may accept any and all appropriate revenue 1147
sources, donations and grants of money, equipment, supplies, 1148
materials and services. 1149
Committee Bill No. 9
LCO No. 6017 41 of 56
(3) The commission may levy on and collect an annual assessment 1150
from each member state or impose fees on other parties to cover the 1151
cost of the operations and activities of the commission and its staff, 1152
which shall be in a total amount sufficient to cover its annual budget as 1153
approved each year for which revenue is not provided by other 1154
sources. The aggregate annual assessment amount shall be allocated 1155
based upon a formula to be determined by the commission, which 1156
shall promulgate a rule binding upon all member states. 1157
(4) The commission shall not incur obligations of any kind prior to 1158
securing the funds adequate to meet such obligations, or pledge the 1159
credit of any of the member states, except by and with the authority of 1160
the member state. 1161
(5) The commission shall keep accurate accounts of all receipts and 1162
disbursements. The receipts and disbursements of the commission 1163
shall be subject to the audit and accounting procedures established 1164
under its bylaws. All receipts and disbursements of funds handled by 1165
the commission shall be audited annually by a certified or licensed 1166
public accountant and the report of the audit shall be included in and 1167
become part of the annual report of the commission. 1168
(g) Qualified Immunity, Defense and Indemnification 1169
(1) The members, officers, executive director, employees and 1170
representatives of the commission shall be immune from suit and 1171
liability, either personally or in their official capacity, for any claim for 1172
damage to or loss of property or personal injury or other civil liability 1173
caused by or arising out of any actual or alleged act, error or omission 1174
that occurred or that the person against whom the claim is made had a 1175
reasonable basis for believing occurred within the scope of commission 1176
employment, duties or responsibilities, provided nothing in this 1177
subdivision shall be construed to protect any such person from suit or 1178
liability for any damage, loss, injury or liability caused by the 1179
intentional or wilful or wanton misconduct of such person. 1180
Committee Bill No. 9
LCO No. 6017 42 of 56
(2) The commission shall defend any member, officer, executive 1181
director, employee or representative of the commission in any civil 1182
action seeking to impose liability arising out of any actual or alleged 1183
act, error or omission that occurred within the scope of commission 1184
employment, duties or responsibilities or that the person against 1185
whom the claim is made had a reasonable basis for believing occurred 1186
within the scope of commission employment, duties or responsibilities, 1187
provided (A) nothing in this subdivision shall be construed to prohibit 1188
such person from retaining his or her own counsel, and (B) the actual 1189
or alleged act, error or omission did not result from such person's 1190
intentional or wilful or wanton misconduct. 1191
(3) The commission shall indemnify and hold harmless any 1192
member, officer, executive director, employee or representative of the 1193
commission for the amount of any settlement or judgment obtained 1194
against such person arising out of any actual or alleged act, error or 1195
omission that occurred within the scope of commission employment, 1196
duties or responsibilities or that such person had a reasonable basis for 1197
believing occurred within the scope of commission employment, 1198
duties or responsibilities, provided the actual or alleged act, error or 1199
omission did not result from the intentional or wilful or wanton 1200
misconduct of such person. 1201
SECTION 8. DATA SYSTEM 1202
(a) The commission shall provide for the development, maintenance 1203
and utilization of a coordinated database and reporting system 1204
containing licensure, adverse action and investigative information on 1205
all licensed individuals in member states. 1206
(b) Notwithstanding any other provision of state law to the 1207
contrary, a member state shall submit a uniform data set to the data 1208
system on all individuals to whom the compact is applicable as 1209
required by the rules of the commission, including: 1210
(1) Identifying information; 1211
Committee Bill No. 9
LCO No. 6017 43 of 56
(2) Licensure data; 1212
(3) Adverse actions against a license or compact privilege; 1213
(4) Nonconfidential information related to alternative program 1214
participation; 1215
(5) Any denial of application for licensure, and the reason for such 1216
denial; and 1217
(6) Other information that may facilitate the administration of the 1218
compact, as determined by the rules of the commission. 1219
(c) Investigative information pertaining to a licensee in any member 1220
state shall only be available to other party states. 1221
(d) The commission shall promptly notify all member states of any 1222
adverse action taken against a licensee or an individual applying for a 1223
license. Adverse action information pertaining to a licensee in any 1224
member state shall be available to any other member state. 1225
(e) Member states contributing information to the data system may 1226
designate information that may not be shared with the public without 1227
the express permission of the contributing state. 1228
(f) Any information submitted to the data system that is 1229
subsequently required to be expunged by the laws of the member state 1230
contributing the information shall be removed from the data system. 1231
SECTION 9. RULEMAKING 1232
(a) The commission shall exercise its rulemaking powers pursuant 1233
to the criteria set forth in this section and the rules adopted 1234
thereunder. Rules and amendments shall become binding as of the 1235
date specified in each rule or amendment. 1236
(b) If a majority of the legislatures of the member states rejects a 1237
rule, by enactment of a statute or resolution in the same manner used 1238
Committee Bill No. 9
LCO No. 6017 44 of 56
to adopt the compact not later than four years after the date of 1239
adoption of the rule, such rule shall have no further force and effect in 1240
any member state. 1241
(c) Rules or amendments to the rules shall be adopted at a regular or 1242
special meeting of the commission. 1243
(d) Prior to promulgation and adoption of a final rule or rules by the 1244
commission, and at least thirty days in advance of the meeting at 1245
which the rule will be considered and voted upon, the commission 1246
shall file a notice of proposed rulemaking: 1247
(1) On the Internet web site of the commission or other publicly 1248
accessible platform; and 1249
(2) On the Internet web site of each member state physical therapy 1250
licensing board or other publicly accessible platform or the publication 1251
in which each state would otherwise publish proposed rules. 1252
(e) The notice of proposed rulemaking shall include: 1253
(1) The proposed time, date and location of the meeting in which the 1254
rule will be considered and voted upon; 1255
(2) The text of the proposed rule or amendment and the reason for 1256
the proposed rule; 1257
(3) A request for comments on the proposed rule from any 1258
interested person; and 1259
(4) The manner in which interested persons may submit notice to 1260
the commission of their intention to attend the public hearing and any 1261
written comments. 1262
(f) Prior to adoption of a proposed rule, the commission shall allow 1263
persons to submit written data, facts, opinions and arguments, which 1264
shall be made available to the public. 1265
Committee Bill No. 9
LCO No. 6017 45 of 56
(g) The commission shall grant an opportunity for a public hearing 1266
before it adopts a rule or amendment if a hearing is requested by: 1267
(1) At least twenty-five persons; 1268
(2) A state or federal governmental subdivision or agency; or 1269
(3) An association having at least twenty-five members. 1270
(h) If a hearing is held on the proposed rule or amendment, the 1271
commission shall publish the place, time and date of the scheduled 1272
public hearing. If the hearing is held via electronic means, the 1273
commission shall publish the mechanism for access to the electronic 1274
hearing. 1275
(1) All persons wishing to be heard at the hearing shall notify the 1276
executive director of the commission or other designated member in 1277
writing of their desire to appear and testify at the hearing not less than 1278
five business days before the scheduled date of the hearing. 1279
(2) Hearings shall be conducted in a manner providing each person 1280
who wishes to comment a fair and reasonable opportunity to comment 1281
orally or in writing. 1282
(3) All hearings shall be recorded. A copy of the recording shall be 1283
made available on request. 1284
(4) Nothing in this section shall be construed as requiring a separate 1285
hearing on each rule. Rules may be grouped for the convenience of the 1286
commission at hearings required by this section. 1287
(i) Following the scheduled hearing date, or by the close of business 1288
on the scheduled hearing date if the hearing was not held, the 1289
commission shall consider all written and oral comments received. 1290
(j) If no written notice of intent to attend the public hearing by 1291
interested parties is received, the commission may proceed with 1292
promulgation of the proposed rule without a public hearing. 1293
Committee Bill No. 9
LCO No. 6017 46 of 56
(k) The commission shall, by majority vote of all members, take final 1294
action on the proposed rule and shall determine the effective date of 1295
the rule, if any, based on the rulemaking record and the full text of the 1296
rule. 1297
(l) Upon determination that an emergency exists, the commission 1298
may consider and adopt an emergency rule without prior notice, 1299
opportunity for comment or hearing, provided the usual rulemaking 1300
procedures provided in the compact and in this section shall be 1301
retroactively applied to the rule as soon as reasonably possible, but in 1302
no event later than ninety days after the effective date of the rule. For 1303
the purposes of this subsection, an emergency rule shall be adopted 1304
immediately to: 1305
(1) Meet an imminent threat to public health, safety or welfare; 1306
(2) Prevent a loss of commission or member state funds; 1307
(3) Meet a deadline for the promulgation of an administrative rule 1308
that is established by federal law or rule; or 1309
(4) Protect public health and safety. 1310
(m) The commission or an authorized committee of the commission 1311
may direct revisions to a previously adopted rule or amendment for 1312
purposes of correcting typographical errors, errors in format, errors in 1313
consistency or grammatical errors. Public notice of any revisions shall 1314
be posted on the Internet web site of the commission. The revision 1315
shall be subject to challenge by any person for a period of thirty days 1316
after posting. The revision may be challenged only on grounds that the 1317
revision results in a material change to a rule. A challenge shall be 1318
made in writing and delivered to the chair of the commission prior to 1319
the end of the notice period. If no challenge is made, the revision shall 1320
take effect without further action. If the revision is challenged, the 1321
revision may not take effect without the approval of the commission. 1322
SECTION 10. OVERSIGHT, DISPUTE RESOLUTION AND 1323
Committee Bill No. 9
LCO No. 6017 47 of 56
ENFORCEMENT 1324
(a) Oversight 1325
(1) The executive, legislative and judicial branches of state 1326
government in each member state shall enforce the compact and take 1327
all actions necessary and appropriate to effectuate the compact's 1328
purposes and intent. The provisions of the compact and the rules 1329
promulgated under the compact shall have standing as statutory law. 1330
(2) All courts shall take judicial notice of the compact and the rules 1331
in any judicial or administrative proceeding in a member state 1332
pertaining to the subject matter of the compact which may affect the 1333
powers, responsibilities or actions of the commission. 1334
(3) The commission shall be entitled to receive service of process in 1335
any such proceeding and shall have standing to intervene in such a 1336
proceeding for all purposes. Failure to provide service of process to the 1337
commission shall render a judgment or order void as to the 1338
commission, the compact or promulgated rules. 1339
(b) Default, Technical Assistance and Termination 1340
(1) If the commission determines that a member state has defaulted 1341
in the performance of its obligations or responsibilities under the 1342
compact or the promulgated rules, the commission shall: 1343
(A) Provide written notice to the defaulting state and other member 1344
states of the nature of the default, the proposed means of curing the 1345
default, and or any other action to be taken by the commission; and 1346
(B) Provide remedial training and specific technical assistance 1347
regarding the default. 1348
(2) If a state in default fails to cure the default, the defaulting state 1349
may be terminated from the compact upon an affirmative vote of a 1350
majority of the member states, and all rights, privileges and benefits 1351
Committee Bill No. 9
LCO No. 6017 48 of 56
conferred by the compact may be terminated on the effective date of 1352
termination. A cure of the default shall not relieve the offending state 1353
of obligations or liabilities incurred during the period of default. 1354
(3) Termination of membership in the compact shall be imposed 1355
only after all other means of securing compliance have been exhausted. 1356
Notice of intent to suspend or terminate shall be given by the 1357
commission to the governor, the majority and minority leaders of the 1358
defaulting state's legislature and each of the member states. 1359
(4) A state that has been terminated is responsible for all 1360
assessments, obligations and liabilities incurred through the effective 1361
date of termination, including obligations that extend beyond the 1362
effective date of termination. 1363
(5) The commission shall not bear any costs related to a state that is 1364
found to be in default or that has been terminated from the compact, 1365
unless agreed upon in writing between the commission and the 1366
defaulting state. 1367
(6) The defaulting state may appeal the action of the commission by 1368
petitioning the United States District Court for the District of Columbia 1369
or the federal district where the commission has its principal offices. 1370
The prevailing member shall be awarded all costs of such litigation, 1371
including reasonable attorney's fees. 1372
(c) Dispute resolution. 1373
(1) Upon request by a member state, the commission shall attempt 1374
to resolve disputes related to the compact that arise among member 1375
states and between member and nonmember states. 1376
(2) The commission shall promulgate a rule providing for both 1377
mediation and binding dispute resolution for disputes as appropriate. 1378
(d) Enforcement 1379
Committee Bill No. 9
LCO No. 6017 49 of 56
(1) The commission, in the reasonable exercise of its discretion, shall 1380
enforce the provisions and rules of the compact. 1381
(2) By majority vote, the commission may initiate legal action in the 1382
United States District Court for the District of Columbia or the federal 1383
district where the commission has its principal offices against a 1384
member state in default to enforce compliance with the provisions of 1385
the compact and its promulgated rules and bylaws. The relief sought 1386
may include both injunctive relief and damages. In the event judicial 1387
enforcement is necessary, the prevailing member shall be awarded all 1388
costs of such litigation, including reasonable attorney's fees. 1389
(3) The remedies herein shall not be the exclusive remedies of the 1390
commission. The commission may pursue any other remedies 1391
available under federal or state law. 1392
SECTION 11. DATE OF IMPLEMENTATION OF THE 1393
INTERSTATE COMMISSION FOR PHYSICAL THERAPY PRACTICE 1394
AND ASSOCIATED RULES, WITHDRAWAL AND AMENDMENT 1395
(a) The compact shall come into effect on the date on which the 1396
compact statute is enacted into law in the tenth member state. The 1397
provisions, which become effective at such time, shall be limited to the 1398
powers granted to the commission relating to assembly and the 1399
promulgation of rules. Thereafter, the commission shall meet and 1400
exercise rulemaking powers necessary to the implementation and 1401
administration of the compact. 1402
(b) Any state that joins the compact subsequent to the commission's 1403
initial adoption of the rules shall be subject to the rules as they exist on 1404
the date on which the compact becomes law in such state. Any rule 1405
that has been previously adopted by the commission shall have the full 1406
force and effect of law on the day the compact becomes law in such 1407
state. 1408
(c) Any member state may withdraw from the compact by enacting 1409
Committee Bill No. 9
LCO No. 6017 50 of 56
a statute repealing the same. 1410
(1) A member state's withdrawal shall not take effect until six 1411
months after enactment of the repealing statute. 1412
(2) Withdrawal shall not affect the continuing requirement of the 1413
withdrawing state's physical therapy licensing board to comply with 1414
the investigative and adverse action reporting requirements of the 1415
compact prior to the effective date of withdrawal. 1416
(d) Nothing contained in the compact shall be construed to 1417
invalidate or prevent any physical therapy licensure agreement or 1418
other cooperative arrangement between a member state and a 1419
nonmember state that does not conflict with the provisions of the 1420
compact. 1421
(e) The compact may be amended by the member states. No 1422
amendment to the compact shall become effective and binding upon 1423
any member state until it is enacted into the laws of all member states. 1424
SECTION 12. CONSTRUCTION AND SEVERABILITY 1425
The compact shall be liberally construed so as to effectuate the 1426
purposes thereof. The provisions of the compact shall be severable, 1427
and if any phrase, clause, sentence or provision of the compact is 1428
declared to be contrary to the constitution of any party state or the 1429
Constitution of the United States, or the applicability thereof to any 1430
government, agency, person or circumstance is held invalid, the 1431
validity of the remainder of the compact and the applicability thereof 1432
to any government, agency, person or circumstance shall not be 1433
affected thereby. If the compact shall be held contrary to the 1434
constitution of any party state, the compact shall remain in full force 1435
and effect as to the remaining party states and in full force and effect as 1436
to the party state affected as to all severable matters." 1437
Sec. 21. (Effective July 1, 2023) (a) The Commissioner of Public Health 1438
shall establish a podiatric scope of practice working group to advise 1439
Committee Bill No. 9
LCO No. 6017 51 of 56
the Department of Public Health and any relevant scope of practice 1440
review committee established pursuant to section 19a-16e of the 1441
general statutes regarding the scope of practice of podiatrists as it 1442
relates to surgical procedures. The working group shall consist of not 1443
less than three podiatrists licensed pursuant to chapter 375 of the 1444
general statutes and not less than three orthopedic surgeons licensed 1445
pursuant to chapter 370 of the general statutes appointed by the 1446
commissioner. Not later than January 1, 2024, the working group shall 1447
report to the commissioner and any such scope of practice review 1448
committee regarding its findings and recommendations. 1449
(b) Not later than February 1, 2024, the Commissioner of Public 1450
Health shall report, in accordance with the provisions of section 11-4a 1451
of the general statutes, to the joint standing committee of the General 1452
Assembly having cognizance of matters relating to public health on the 1453
findings and recommendations of the working group and whether the 1454
Department of Public Health and any relevant scope of practice review 1455
committee is in agreement with such findings and recommendations. 1456
Sec. 22. Section 20-94a of the general statutes is repealed and the 1457
following is substituted in lieu thereof (Effective October 1, 2023): 1458
(a) The Department of Public Health may issue an advanced 1459
practice registered nurse license to a person seeking to perform the 1460
activities described in subsection (b) of section 20-87a, upon receipt of 1461
a fee of two hundred dollars, to an applicant who: (1) Maintains a 1462
license as a registered nurse in this state, as provided by section 20-93 1463
or 20-94; (2) holds and maintains current certification as a nurse 1464
practitioner, a clinical nurse specialist or a nurse anesthetist from one 1465
of the following national certifying bodies that certify nurses in 1466
advanced practice: The American Nurses' Association, the Nurses' 1467
Association of the American College of Obstetricians and 1468
Gynecologists Certification Corporation, the National Board of 1469
Pediatric Nurse Practitioners and Associates or the American 1470
Association of Nurse Anesthetists, their successors or other 1471
Committee Bill No. 9
LCO No. 6017 52 of 56
appropriate national certifying bodies approved by the Board of 1472
Examiners for Nursing; (3) has completed thirty hours of education in 1473
pharmacology for advanced nursing practice; and (4) (A) holds a 1474
graduate degree in nursing or in a related field recognized for 1475
certification as either a nurse practitioner, a clinical nurse specialist, or 1476
a nurse anesthetist by one of the foregoing certifying bodies, or (B) (i) 1477
on or before December 31, 2004, completed an advanced nurse 1478
practitioner program that a national certifying body identified in 1479
subdivision (2) of subsection (a) of this section recognized for 1480
certification of a nurse practitioner, clinical nurse specialist, or nurse 1481
anesthetist, and (ii) at the time of application, holds a current license as 1482
an advanced practice registered nurse in another state that requires a 1483
master's degree in nursing or a related field for such licensure. No 1484
license shall be issued under this section to any applicant against 1485
whom professional disciplinary action is pending or who is the subject 1486
of an unresolved complaint. 1487
(b) During the period commencing January 1, 1990, and ending 1488
January 1, 1992, the Department of Public Health may in its discretion 1489
allow a registered nurse, who has been practicing as an advanced 1490
practice registered nurse in a nurse practitioner role and who is unable 1491
to obtain certification as a nurse practitioner by one of the national 1492
certifying bodies specified in subsection (a) of this section, to be 1493
licensed as an advanced practice registered nurse provided the 1494
individual: 1495
(1) Holds a current Connecticut license as a registered nurse 1496
pursuant to this chapter; 1497
(2) Presents the department with documentation of the reasons one 1498
of such national certifying bodies will not certify him as a nurse 1499
practitioner; 1500
(3) Has been in active practice as a nurse practitioner for at least five 1501
years in a facility licensed pursuant to section 19a-491; 1502
Committee Bill No. 9
LCO No. 6017 53 of 56
(4) Provides the department with documentation of his preparation 1503
as a nurse practitioner; 1504
(5) Provides the department with evidence of at least seventy-five 1505
contact hours, or its equivalent, of continuing education related to his 1506
nurse practitioner specialty in the preceding five calendar years; 1507
(6) Has completed thirty hours of education in pharmacology for 1508
advanced nursing practice; 1509
(7) Has his employer provide the department with a description of 1510
his practice setting, job description, and a plan for supervision by a 1511
licensed physician; 1512
(8) Notifies the department of each change of employment to a new 1513
setting where he will function as an advanced practice registered nurse 1514
and will be exercising prescriptive and dispensing privileges. 1515
(c) Any person who obtains a license pursuant to subsection (b) of 1516
this section shall be eligible to renew such license annually provided 1517
he presents the department with evidence that he received at least 1518
fifteen contact hours, or its equivalent, eight hours of which shall be in 1519
pharmacology, of continuing education related to his nurse 1520
practitioner specialty in the preceding licensure year. If an individual 1521
licensed pursuant to subsection (b) of this subsection becomes eligible 1522
at any time for certification as a nurse practitioner by one of the 1523
national certifying bodies specified in subsection (a) of this section, the 1524
individual shall apply for certification, and upon certification so notify 1525
the department, and apply to be licensed as an advanced practice 1526
registered nurse in accordance with subsection (a) of this section. 1527
(d) On and after October 1, 2023, a person, who is not eligible for 1528
licensure under subsection (a) of this section, may apply for licensure 1529
by endorsement as an advanced practice registered nurse. Such 1530
applicant shall (1) present evidence satisfactory to the Commissioner 1531
of Public Health that the applicant has acquired three years of 1532
Committee Bill No. 9
LCO No. 6017 54 of 56
experience as an advanced practice registered nurse, or as a person 1533
entitled to perform similar services under a different designation, in 1534
another state or jurisdiction that has requirements for practicing in 1535
such capacity that are substantially similar to, or higher than, those of 1536
this state and that there are no disciplinary actions or unresolved 1537
complaints pending against such person, and (2) pay a fee of two 1538
hundred dollars to the commissioner. 1539
[(d)] (e) A person who has received a license pursuant to this section 1540
shall be known as an "Advanced Practice Registered Nurse" and no 1541
other person shall assume such title or use the letters or figures which 1542
indicate that the person using the same is a licensed advanced practice 1543
registered nurse. 1544
Sec. 23. Section 10a-19l of the general statutes is repealed and the 1545
following is substituted in lieu thereof (Effective July 1, 2023): 1546
(a) Not later than January 1, 2023, the Office of Higher Education 1547
shall establish a health care provider loan reimbursement program. 1548
The health care provider loan reimbursement program shall provide 1549
loan reimbursement grants to health care providers licensed by the 1550
Department of Public Health who are employed full-time as a health 1551
care provider in the state. 1552
(b) The executive director of the Office of Higher Education shall (1) 1553
develop, in consultation with the Department of Public Health, 1554
eligibility requirements for recipients of such loan reimbursement 1555
grants, which requirements may include, but need not be limited to, 1556
income guidelines, [and] (2) award at least twenty per cent of such 1557
loan reimbursement grants to graduates of a regional community-1558
technical college, and (3) award at least ten per cent of such loan 1559
reimbursement grants to persons employed full-time as health care 1560
providers in a rural community in the state. The executive director 1561
shall consider health care workforce shortage areas when developing 1562
such eligibility requirements. A person who qualifies for a loan 1563
reimbursement grant shall be reimbursed on an annual basis for 1564
Committee Bill No. 9
LCO No. 6017 55 of 56
qualifying student loan payments in amounts determined by the 1565
executive director. A health care provider shall only be reimbursed for 1566
loan payments made while such person is employed full-time in the 1567
state as a health care provider. Persons may apply for loan 1568
reimbursement grants to the Office of Higher Education at such time 1569
and in such manner as the executive director prescribes. 1570
(c) The Office of Higher Education may accept gifts, grants and 1571
donations, from any source, public or private, for the health care 1572
provider loan reimbursement program. 1573
Sec. 24. (NEW) (Effective July 1, 2023) Not later than January 1, 2024, 1574
the owner or operator of each splash pad and spray park where water 1575
is recirculated shall post a sign in a conspicuous location at or near the 1576
entryway to the splash pad or spray park stating that the water is 1577
recirculated and warning that there is a potential health risk to persons 1578
ingesting the water. 1579
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Sec. 2 July 1, 2023 New section
Sec. 3 October 1, 2023 New section
Sec. 4 from passage New section
Sec. 5 from passage New section
Sec. 6 October 1, 2023 New section
Sec. 7 October 1, 2023 20-14o
Sec. 8 July 1, 2023 New section
Sec. 9 July 1, 2023 20-633d(a)
Sec. 10 July 1, 2023 New section
Sec. 11 from passage New section
Sec. 12 July 1, 2023 New section
Sec. 13 July 1, 2023 New section
Sec. 14 July 1, 2023 New section
Sec. 15 July 1, 2023 New section
Sec. 16 October 1, 2023 New section
Sec. 17 July 1, 2023 20-14p
Committee Bill No. 9
LCO No. 6017 56 of 56
Sec. 18 July 1, 2023 New section
Sec. 19 from passage New section
Sec. 20 July 1, 2023 New section
Sec. 21 July 1, 2023 New section
Sec. 22 October 1, 2023 20-94a
Sec. 23 July 1, 2023 10a-19l
Sec. 24 July 1, 2023 New section
Statement of Purpose:
To equalize access to physical, mental and behavioral health care in the
state and to strengthen the state's response to the fentanyl and opioid
epidemic.
[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.]
Co-Sponsors: SEN. LOONEY, 11th Dist.; SEN. DUFF, 25th Dist.
SEN. ANWAR, 3rd Dist.; SEN. CABRERA, 17th Dist.
SEN. COHEN, 12th Dist.; SEN. FLEXER, 29th Dist.
SEN. FONFARA, 1st Dist.; SEN. GASTON, 23rd Dist.
SEN. HOCHADEL, 13th Dist.; SEN. KUSHNER, 24th Dist.
SEN. LESSER, 9th Dist.; SEN. LOPES, 6th Dist.
SEN. MAHER, 26th Dist.; SEN. MARONEY, 14th Dist.
SEN. MARX, 20th Dist.; SEN. MCCRORY, 2nd Dist.
SEN. MILLER P., 27th Dist.; SEN. MOORE, 22nd Dist.
SEN. RAHMAN, 4th Dist.; SEN. SLAP, 5th Dist.
SEN. WINFIELD, 10th Dist.
S.B. 9