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