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