OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
sSB-9
AN ACT CONCERNING HEALTH AND WELLNESS FOR
CONNECTICUT RESIDENTS.
Primary Analyst: RDP 4/11/23
Contributing Analyst(s): SB, DD, LD, ME, LG, RP, ES
Reviewer: PR
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 24 $ FY 25 $
Opioid Antagonist Bulk
Purchase Fund
Cost See Below See Below
Mental Health & Addiction
Serv., Dept.
GF - Cost at least
283,600
at least
290,700
State Comptroller - Fringe
Benefits
1
GF - Cost at least
121,438
at least
124,478
Public Health, Dept. GF - Cost 122,294 None
Higher Ed., Off. GF - Cost 75,000 75,000
State Comptroller - Fringe
Benefits
GF - Cost 32,115 32,115
Higher Ed., Off. GF - Cost Significant Significant
Social Services, Dept. GF - Cost at least
175,000
at least
179,400
State Comptroller - Fringe
Benefits
GF - Cost at least
74,900
at least
76,800
UConn Health Ctr. GF - Potential
Revenue Loss
Significant Significant
Resources of the General Fund GF - Revenue Loss 38,712 38,172
Resources of the General Fund GF - Revenue Gain 25,950 25,950
Applicant Fingerprint Card
Submission Account
Potential Revenue
Gain
Up to 5,190 Up to 5,190
Note: GF=General Fund
Municipal Impact:
Municipalities Effect FY 24 $ FY 25 $
Various Municipalities Revenue Gain Potential Potential
1
The fringe benefit costs for most state employees are budgeted centrally in accounts
administered by the Comptroller. The estimated active employee fringe benefit cost
associated with most personnel changes is 42.82% of payroll in FY 24. 2023SB-00009-R000507-FN.DOCX Page 2 of 5
Explanation
The bill results in a potential revenue gain to municipalities
beginning in FY 24, a corresponding cost to the Opioid Antagonist Bulk
Purchase Fund beginning in FY 24, a cost to the Department of Mental
Health and Addiction Services (DMHAS) of at least $283,600 in FY 24
and $290,700 in FY 25, with an associated fringe benefits cost of at least
$121,438 in FY 24 and $124,478 in FY 25, a cost to the Department of
Public Health (DPH) of $122,294 in FY 24 only, a cost to the Office of
Higher Education (OHE) of $75,000 annually, with an associated fringe
benefits cost of $32,115 annually, a cost to the Department of Social
Services (DSS) of at least $175,000 in FY 24 and $179,400 in FY 25, with
an associated fringe benefits cost of at least $74,900 in FY 24 and $76,800
in FY 25, a significant potential revenue loss to the UConn Health Center
annually, a revenue loss to the General Fund of $38,712 annually, a
revenue gain to the General Fund of $25,950 annually, and a potential
revenue gain to the Applicant Fingerprint Card Submission Account of
up to $5,190 annually.
The fiscal impacts of the bill are broken out by section below. Other
provisions of the bill are not anticipated to result in a fiscal impact to the
State or municipalities.
Sections 3 and 4 require DMHAS to establish harm reduction centers
in three municipalities. The purpose of the pilot program is to prevent
drug overdoses and provide a medical facility where individuals with
substance use disorder can receive counseling, educational, and referral
services, access basic support services, and may safely consume
controlled substances under the observation of licensed health care
providers. The extent of the cost to DMHAS to either: (1) establish and
staff such facilities, and/or (2) contract with providers able to meet the
pilot program requirements, depends on the scope of the three pilot
locations, to be determined by the agency. At minimum, DMHAS will
incur a cost of at least $176,800 in FY 24 and $181,200 in FY 25, with an
associated fringe benefits cost of $75,700 in FY 24 and $77,600 in FY 25, 2023SB-00009-R000507-FN.DOCX Page 3 of 5
for staff to oversee the program and work with the Harm Reduction
Center Pilot Program Advisory Committee.
Section 5 makes local or regional boards of education, local or district
departments of health, and law enforcement agencies eligible for grants
through DMHAS from the Opioid Antagonist Bulk Purchase Fund. This
results in a potential revenue gain to municipalities beginning in FY 24
subject to the number, and the amount, of the grants awarded, a
corresponding cost to the Fund, and a cost to DMHAS for staff of at least
$106,800 in FY 24 and $109,500 in FY 25 to administer the grant program,
with an associated fringe benefits cost of $45,700 in FY 24 and $46,900 in
FY 25.
2
Section 10 results in a cost to DPH of $122,294 in FY 24 only
3
for a
Senior Healthcare Strategic Planning Consultant to coordinate a
working group, facilitate meetings, conduct research, as well as draft
and, no later than 1/1/24, submit, a final report that includes five- and
ten-year plans for increasing the nursing workforce in the State.
Sections 11 and 12 result in a cost to OHE of $75,000 annually, and a
cost for fringe benefits of $32,115 annually, associated with hiring one
full-time Senior Consultant to establish and administer a program that
gives incentive grants to licensed health care providers accepting
adjunct professor positions.
This program will also result in a significant cost to OHE associated
with the provision of grant payments to eligible adjunct faculty. The
scope of the cost would be dependent on: (1) the number of grant
applicants, (2) the amount of the grants awarded, and (3) grant duration.
Each person's grant is required to be equal to the difference between the
person's salary as a provider and the person's salary as an adjunct
professor, and the grant is to be provided by OHE for the duration of
the awardee's adjunct professorship.
2
DMHAS may use up to 2% of the account in any fiscal year for related administrative
expenses.
3
This reflects 960 consultant hours at a rate of 127.39 per hour. 2023SB-00009-R000507-FN.DOCX Page 4 of 5
Section 14 results in a cost of at least $175,000 in FY 24 and $179,400
in FY 25 to DSS, with an associated fringe benefits cost of $74,900 in FY
24 and $76,800 in FY 25, for a Program Manager and administrative staff
to establish, by 1/1/24, and operate a career pathways program for
Personal Care Attendants.
Sections 16 and 17, which prohibit physician and advanced practice
registered nurse (APRN) non-compete agreements (“covenants not to
compete”) entered into, amended, or renewed on or after 7/1/23, could
result in a significant revenue loss to the UConn Health Center.
National data indicates that each physician affiliated with a hospital
generates, on average, nearly $2.4 million in net revenue annually. Net
revenue per physician varies, with certain specialists netting a hospital
$3 million and above, while primary care physicians net approximately
$2 million. If four established physicians with an average net revenue of
$2.4 million leave the UConn Health Center, because they are no longer
bound by non-compete clauses, the annual revenue loss to the UConn
Health Center would be $9.6 million.
The extent of the UConn Health Center’s annual revenue loss
associated with these sections is dependent on: (1) the number of
established physicians/APRNs who depart the UConn Health Center,
(2) the net revenue of each departing physician/APRN, and (3) the
UConn Health Center’s ability to offset revenue losses through
recruitment of established physicians/APRNs from nearby hospitals or
practices.
Section 19, which requires Connecticut to join the Physical Therapy
Licensure Compact, is estimated to result in a total annual General Fund
revenue loss of $38,712. It is anticipated that DPH will receive 100 less
initial Physical Therapist (PT) applications ($28,500), 75 less PT renewals
($7,857), 9 less initial PT Assistant applications ($1,900), and 7 less PT
Assistant renewals ($455) annually due to joining the compact.
Section 20 requires persons applying for PT licensure to submit to
fingerprint-based state background checks, resulting in a revenue gain
to the General Fund of $25,950 in both FY 24 and FY 25, and a potential 2023SB-00009-R000507-FN.DOCX Page 5 of 5
revenue gain to the Applicant Fingerprint Card Submission Account of
up to $5,190 in both FY 24 and FY 25. The Department of Emergency
Services and Public Protection (DESPP) conducts state background
checks for a fee of $75 per check, and the revenue that is collected from
this fee is deposited into the General Fund ($75 x 364 PT and PT
Assistant applicants
4
= $25,950). If DESPP conducts fingerprinting of all
applicants for PT licensure, with a $15 fee per person paid to the
Applicant Fingerprint Card Submission Account, there would be a
revenue gain to this Account of up to $5,190.
5
As third-party providers
may complete fingerprinting instead of DESPP, Account revenue is
reflected as potential.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to the amount of Opioid Antagonist
Bulk Purchase Fund grants awarded to municipalities, the number of
Physical Therapy Licensure Compact licenses issued by DPH, the
number of adjunct faculty incentive grant applicants, the amount of
grants awarded, grant duration, the number of established
physicians/APRNs who depart the UConn Health Center, the net
revenue of each departing physician/APRN, UConn Health Center’s
ability to offset revenue losses through recruitment of established
physicians/APRNs from nearby hospitals or practices, the number of
state background checks completed by DESPP , the number of
fingerprints completed by DESPP, and inflation.
4
This estimate is based on the number of initial PT and PT Assistant applications
received by DPH in FY 22, minus the loss of initial applications anticipated from
entering the Physical Therapist Licensure Compact per Section 19 of the bill. The total
reflects 285 initial PT applications, and 61 initial PT Assistant applications, in both FY
24 and FY 25.
5
Funds in the non-lapsing Applicant Fingerprint Card Submission Account are used
for IT support and maintenance for the fingerprinting systems.