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OLR Bill Analysis
sSB 9 (File 507, as amended by Senate "A" and "C")*
AN ACT CONCERNING HEALTH AND WELLNESS FOR
CONNECTICUT RESIDENTS.
TABLE OF CONTENTS:
§ 1 — ASSISTED REPRODUCTIVE TECHNOLOGY A ND ASSISTED
REPRODUCTION
Prohibits anyone from barring or unreasonably limiting (1) anyone from accessing ART
or assisted reproduction or (2) authorized providers from performing these procedures,
and makes related changes
§ 2 — MEDICAID FUNDING FOR LONG-ACTING REVERSIBLE
CONTRACEPTIVES
Conforms to existing DSS policy by requiring Medicaid coverage for same-day access to
long-acting reversible contraceptives at federally qualified health centers
§§ 3 & 4 — DRUG USE HARM REDUCTION CENTE RS
Requires DMHAS, by July 1, 2027, to create a pilot program establishing harm reduction
centers where people with substance use disorder can access counseling, receive and use
fentanyl or xylazine test strips, and receive various other services; exempts the centers
from DPH regulation until after the pilot program ends; exempts the centers from needing
CON approval
§ 5 — OPIOID ANTAGONIST BULK PURCHASE FUND AND EMS
PROVIDING OPIOID ANTAGONIST KITS
Creates an Opioid Antagonist Bulk Purchase Fund, which DMHAS must use to give
opioid antagonists to municipalities, other eligible entities, and EMS personnel; requires
EMS personnel to provide kits with opioid antagonists and an opioid-related fact sheet to
certain patients, such as those showing symptoms of opioid use disorder
§ 6 — ENCOURAGEMENT TO OBTAIN OPIOID ANTAGONIST
Requires prescribing practitioners, when prescribing an opioid, to encourage the patient
(and parents or guardian when applicable) to obtain an opioid antagonist
§ 7 — SDE HEALTH CARE CAREER PROMOTION
Requires the education commissioner to use an existing plan to promote health care
careers and provide health care job shadowing and internship experiences; requires the
commissioner to give the plan to school boards and support its implementation
§ 8 — HEALTH CARE WOR KFORCE WORKING GROUP
Requires OWS to convene a working group to develop recommendations to expand the
state’s health care workforce 2023SB-00009-R01-BA.DOCX
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§§ 9 & 10 — HEALTH CARE PROVIDERS SERVING AS ADJUNCT
FACULTY
Requires public higher education institutions to consider any licensed health care provider
with at least 10 years of clinical experience to be qualified for an adjunct faculty position;
correspondingly requires the Office of Higher Education, within available appropriations,
to establish a program providing incentive grants to these providers who become adjunct
professors
§ 11 — PERSONAL CARE ATTENDANT CAREER PA THWAYS
PROGRAM
Requires DSS to establish a PCA career pathways program, including both basic skills
and specialized skills pathways, to improve PCAs’ quality of care and incentivize their
recruitment and retention in the state
§ 12 — HOSPITAL PRIVILEGES
Prohibits hospitals, for purposes of granting practice privileges, from requiring (1) board
eligible physicians to become board certified until five years after becoming board eligible,
or (2) board certified physicians to provide credentials of board recertification
§§ 13-15 — PHYSICIAN, APRN, OR PA NON-COMPETE CLAUSES
Places additional limitations on physician non-compete clauses when the physician does
not agree to a material change to the employment contract; extends to APRN or PA non-
compete clauses the limitations that apply to physician non-compete clauses under
existing law and the bill
§ 16 — PHYSICAL THERAPY LICENSURE COMPAC T
Enters Connecticut into the Physical Therapy Licensure Compact, which provides a
process authorizing physical therapists or physical therapy assistants properly
credentialed in one member state to practice across state boundaries, without requiring
licensure in each state
§ 17 — BACKGROUND CH ECKS FOR PT AND PT ASSISTANT
LICENSURE
Requires PT and PT assistant licensure applicants to complete a fingerprint-based
criminal background check
§ 18 — PODIATRIC SCOPE OF PRACTICE WORKING GROUP
Requires DPH to establish a working group to advise the department and any relevant
scope of practice review committee on podiatrists’ scope of practice relating to surgical
procedures
§§ 19 & 20 — APRN LICENSURE BY ENDORSEME NT AND
INDEPENDENT PRACTICE
Allows for licensure by endorsement for APRNs who have (1) practiced for at least three
years in another state with practice requirements that are substantially similar to, or
higher than, Connecticut’s and (2) no disciplinary history or unresolved complaints
pending; correspondingly allows these APRNs to count their out-of-state practice toward
the existing requirement of three years’ practice in collaboration with a physician before
practicing independently
§ 21 — SPLASH PAD AND SPRAY PARK WARNING SIGNS
Requires splash pad and spray park owners or operators to post warning signs about the
potential health risk of ingesting recirculated water 2023SB-00009-R01-BA.DOCX
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§ 22 — LPN EDUCATION PILOT PROGRAM
Allows the state nursing board, under certain conditions, to approve applications from
higher education institutions to create a pilot program for licensed practice nurse
education and training, and grants the program full approval if it meets specified
requirements for two years
§ 23 — RECIPROCITY AGREEMENTS FOR CLINICAL ROTATION
TRAINING
Allows OHE to enter into a reciprocity agreement with neighboring states regarding
clinical training credit at higher education institutions
§ 24 — COMMISSION ON COMMUNITY GUN VIOLENC E
INTERVENTION AND PREVENTION
Specifically allows the Commission on Community Gun Violence Intervention and
Prevention to create a subcommission, an advisory group, or another entity for specified
purposes related to providing home health care and services to people affected by gun
violence
§§ 25 & 26 — MATERNAL MENTAL HEALTH TOOL KIT AND
PERINATAL MOOD AND A NXIETY DISORDER TRAINING
Requires DPH, in consultation with DMHAS and certain other organizations, to develop
a maternal mental health toolkit for providers and patients, including on perinatal mood
and anxiety disorders; requires hospitals to include training in perinatal mood and
anxiety disorders as part of their regular training for certain staff members
§ 27 — EMERGENCY DEPARTMENT CROWDING WOR KING GROUP
Requires the DPH commissioner to convene a working group to advise her on how to
alleviate emergency department crowding and the lack of available beds
§ 28 — PSYCHOSIS TASK FORCE
Creates a task force to study childhood and adult psychosis
§§ 29-34 — EVALUATIONS AND REPORTS RELATED TO PARENTING
AND SUBSTANCE USE DISORDER
Requires DMHAS, DCF, and certain other state agencies to evaluate or report on various
supports and related issues for parents, other child caregivers, or pregnant individuals
with substance use disorder
§ 35 — OPIOID SETTLEMENT FUND ADVISORY COMMITTEE
Adds eight members to the Opioid Settlement Fund Advisory Committee
§ 36 — EMS DATA COLLECTION AND REPORTING
Requires EMS organizations, in their quarterly data reporting, to include the reasons for
9-1-1 calls; requires the DPH commissioner to annually submit EMS data to the Public
Health Committee and expands the reporting requirements to include data on EMS
personnel shortages
§ 37 — RURAL HEALTH TASK FORCE
Creates a task force to study issues concerning rural health
§ 38 — HEALTH CARE MAGNET SCHOOL STUDY 2023SB-00009-R01-BA.DOCX
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Requires the education commissioner, in consultation with the labor and DPH
commissioners, to study the feasibility of establishing an interdistrict magnet school
program focused on training students for health care professions
§ 39 — DELETED BY SENATE AMENDMENT “C”
§ 40 — COMMUNICATION ACCESS STUDY
Requires the aging and disability services commissioner, in consultation with the
Advisory Board for Persons Who are Deaf, Hard of Hearing or Deafblind, to evaluate gaps
in these individuals’ access to communication with medical providers
§§ 41 & 42 — DENTAL ASSISTANTS
Provides an alternate way for dental assistants to qualify to take dental x-rays, by passing
a competency assessment rather than a national exam, and requires UConn’s School of
Dental Medicine to develop the assessment by January 1, 2025
§ 43 — EPINEPHRINE ADMINISTRATION BY EMS PERSONNEL
Requires EMS personnel, under specified conditions, to administer epinephrine using
automatic prefilled cartridge injectors, similar automatic injectable equipment, or prefilled
vials and syringes
§ 44 — MEDICAL RECORDS REQUESTS
Generally sets deadlines for licensed health care institutions to send electronic copies of
patient medical records to another institution upon request
§ 45 — PRACTITIONER SHORTAGE TASK FORCE
Creates a task force to study how to address the state’s shortage of radiologic technologists,
nuclear medicine technologists, and respiratory care practitioners
§§ 46 & 47 — BACKGROUND CHECKS FOR PHYSICIAN AND
PSYCHOLOGIST LICENSURE APPLICANTS
Requires psychologist licensure applicants, and physician applicants who wish to
participate in interstate compacts, to submit to a state and national fingerprint-based
criminal history records check by DESPP
*Senate Amendment “A” makes numerous changes to the bill’s
underlying provisions, such as:
1. setting a July 1, 2027, deadline for the Department of Mental
Health and Addiction Services (DMHAS) to create the harm
reduction center pilot program, requiring these centers to offer
fentanyl and xylazine test strips, and removing provisions on the
centers offering a separate location for safe drug use;
2. requiring opioid prescribers to encourage patients to obtain an
opioid antagonist, rather than requiring prescribers to provide
opioid antagonist prescriptions to certain patients; 2023SB-00009-R01-BA.DOCX
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3. requiring the Office of Workforce Strategy (OWS), rather than the
Department of Public Health (DPH), to convene a working group
on increasing the health care workforce, and expanding the
group’s scope beyond nursing;
4. setting the amount of the grant for health care providers who
become clinical faculty members under the bill’s new grant
program, and requiring the program only within available
appropriations; and
5. setting additional limitations on physician non-compete
agreements and extending the law’s limits to non-compete
agreements for advanced practice registered nurses (APRNs) and
physician assistants (PAs), rather than banning these agreements
for physicians and APRNs as in the underlying bill.
It adds provisions on:
1. APRN independent practice requirements, a licensed practical
nursing (LPN) education pilot program, reciprocity agreements
for clinical rotations, dental assistants administering x-rays, and
background checks for physician and psychologist licensure
applicants;
2. epinephrine administration by emergency medical services
(EMS) personnel, EMS data collection and reporting, and an
emergency department crowding working group;
3. the Commission on Community Gun Violence Intervention and
Prevention;
4. a maternal mental health toolkit and related hospital training;
5. task forces on psychosis, rural health, and shortages in certain
health professions;
6. the Opioid Settlement Fund Advisory Committee’s membership
and various reports related to child caregivers or pregnant
individuals with substance use disorder; 2023SB-00009-R01-BA.DOCX
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7. studies on a health care magnet school program, offering certain
licensure examinations in Spanish, and medical provider
communication gaps for certain people; and
8. deadlines for institutions to respond to medical record requests.
It removes certain provisions from the underlying bill, such as those
that would have (1) created an advisory committee for the harm
reduction center pilot program; (2) required the education
commissioner to create a Health Care Career Advisory Council; (3)
required DPH to offer nurse’s aide competency tests in both English and
Spanish; (4) created a medical malpractice reform task force; and (5)
required the Office of Higher Education (OHE), for purposes of a health
care provider loan reimbursement program, to award at least 10% of
grants to providers working full-time in rural communities.
It also makes minor and conforming changes.
*Senate Amendment “C” removes a provision added by Senate
Amendment “A” that would have required OWS to study the feasibility
of offering competency testing for certain health care professionals in
both Spanish and English.
§ 1 — ASSISTED REPRODUCTIVE TECHNOLOGY A ND ASSISTED
REPRODUCTION
Prohibits anyone from barring or unreasonably limiting (1) anyone from accessing ART
or assisted reproduction or (2) authorized providers from performing these procedures,
and makes related changes
This bill prohibits any person or entity from prohibiting or
unreasonably limiting someone from:
1. accessing assisted reproductive technology (ART) or assisted
reproduction;
2. continuing or completing an ongoing ART or assisted
reproduction treatment or procedure under a written plan or
agreement with a health care provider; or
3. retaining all rights on the use of reproductive genetic materials, 2023SB-00009-R01-BA.DOCX
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such as gametes.
The bill also prohibits anyone from prohibiting or unreasonably
limiting a health care provider who is licensed, certified, or otherwise
authorized to perform ART or assisted reproduction treatments or
procedures from (1) doing so or (2) providing evidence-based
information related to ART or assisted reproduction.
Under the bill, “assisted reproductive technology” includes all
treatments or procedures in which human oocytes (i.e., cells that
develop into eggs) or embryos are handled, such as (1) in vitro
fertilization (IVF) and (2) gamete or zygote intrafallopian transfer (see
42 U.S.C. § 263a-7). “Assisted reproduction” is a method of causing
pregnancy other than sexual intercourse and includes (1) intrauterine,
intracervical, or vaginal insemination; (2) donation of gametes or
embryos; (3) IVF and embryo transfer; and (4) intracytoplasmic sperm
injection (see CGS § 46b-451).
EFFECTIVE DATE: Upon passage
§ 2 — MEDICAID FUNDING FOR LONG -ACTING REVERSIBLE
CONTRACEPTIVES
Conforms to existing DSS policy by requiring Medicaid coverage for same-day access to
long-acting reversible contraceptives at federally qualified health centers
The bill requires the Department of Social Services (DSS)
commissioner to adjust Medicaid reimbursement criteria to cover same-
day access to long-acting reversible contraceptives at federally qualified
health centers. In doing so, the bill conforms to current DSS policy.
The bill defines this type of contraceptive as any contraception
method that does not have to be used more than once per menstrual
cycle or per month.
EFFECTIVE DATE: July 1, 2023
§§ 3 & 4 — DRUG USE HARM REDUCTION CENTE RS
Requires DMHAS, by July 1, 2027, to create a pilot program establishing harm reduction
centers where people with substance use disorder can access counseling, receive and use
fentanyl or xylazine test strips, and receive various other services; exempts the centers 2023SB-00009-R01-BA.DOCX
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from DPH regulation until after the pilot program ends; exempts the centers from needing
CON approval
The bill requires DMHAS, by July 1, 2027, and in consultation with
DPH, to create a pilot program consisting of harm reduction centers to
prevent drug overdoses. Under the bill, these centers must be
established in three municipalities the DMHAS commissioner chooses,
subject to their chief elected officials’ approval.
For this purpose, “harm reduction centers” are medical facilities
where a person with a substance use disorder may (1) receive various
services, such as counseling, treatment referrals, and basic support
services and (2) use test strips to test a substance for fentanyl or certain
other substances (see below).
Under the bill, these centers must employ, among others, licensed
providers with experience treating people with substance use disorders.
The DMHAS commissioner determines the staffing level. The bill
specifies that a health care provider’s participation in the pilot program
is not grounds for disciplinary action by DPH or professional licensing
boards within the department.
The bill allows the DMHAS commissioner to request Opioid
Settlement Fund disbursements to fund the program fully or partially.
Under the bill, these centers are not subject to DPH regulation until
after the pilot program ends. The bill also exempts centers established
through the pilot program from the requirement to obtain certificate of
need (CON) approval from the Office of Health Strategy (OHS).
EFFECTIVE DATE: Upon passage
Harm Reduction Center Services and Providers
The bill requires harm reduction centers under the pilot program to
offer the following services to people with a substance use disorder:
1. substance use disorder and other mental health counseling;
2. use of test strips to prevent accidental overdose (see below); 2023SB-00009-R01-BA.DOCX
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3. educational information about opioid antagonists and the risks
of contracting diseases from sharing hypodermic needles;
4. referrals to substance use disorder treatment services; and
5. access to basic support services, including laundry machines, a
bathroom, a shower, and a place to rest.
The bill requires the centers to offer test strips upon the person’s
request and allow the use of test strips at the center. The purpose of the
strips is to test a substance, before injecting, inhaling, or ingesting it, for
traces of fentanyl, xylazine, or any other substance that the DMHAS
commissioner recognizes as having a high risk of causing an overdose.
(Xylazine is a veterinary tranquilizer that is sometimes mixed with
fentanyl in illegal drug sales.)
The bill requires the centers’ employees to include licensed providers
with experience treating people with substance use disorders. These
providers must (1) provide the aforementioned counseling services and
(2) monitor people using the center and provide treatment to those
experiencing overdose symptoms. The centers must provide referrals
for (1) substance use disorder or mental health counseling or (2) other
mental health or medical treatment services that may be appropriate.
§ 5 — OPIOID ANTAGONIST BULK PURCHASE FU ND AND EMS
PROVIDING OPIOID ANTAGONIST KITS
Creates an Opioid Antagonist Bulk Purchase Fund, which DMHAS must use to give
opioid antagonists to municipalities, other eligible entities, and EMS personnel; requires
EMS personnel to provide kits with opioid antagonists and an opioid-related fact sheet to
certain patients, such as those showing symptoms of opioid use disorder
The bill creates an Opioid Antagonist Bulk Purchase Fund as a
separate, nonlapsing General Fund account. Starting by January 1, 2024,
DMHAS, in collaboration with DPH, must use the account’s funds to
provide opioid antagonists to eligible entities and for EMS personnel to
give this medication to certain members of the public. Relatedly, it
requires EMS personnel to give kits with opioid antagonists and related
information (in a one-page fact sheet) to certain patients or their family
members, caregivers, or friends. 2023SB-00009-R01-BA.DOCX
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As under existing law, an opioid antagonist is naloxone
hydrochloride (e.g., Narcan) or any other similarly acting and equally
safe drug that the Food and Drug Administration (FDA) has approved
for treating a drug overdose.
EFFECTIVE DATE: October 1, 2023
Eligible Entities
Under the bill, “eligible entities” are (1) municipalities, (2) local and
regional boards of education, (3) similar bodies governing nonpublic
schools, (4) district and municipal health departments, (5) law
enforcement agencies, and (6) EMS organizations. The DMHAS
commissioner, within available appropriations, may contract with a
drug wholesaler or distributer to purchase and distribute opioid
antagonists in bulk to eligible entities through the program.
The bill requires eligible entities to make these bulk-purchased opioid
antagonists available, for free, to family members, caregivers, or friends
of people who experienced an opioid overdose or showed overdose
symptoms.
Opioid Antagonist Bulk Purchase Fund
The bill requires the state treasurer to administer the Bulk Purchase
Fund account. The account must contain (1) any state appropriations or
other state money made available for the fund’s purposes; (2) moneys
required by law to be deposited into the account; (3) gifts, grants,
donations, or bequests directed to it; and (4) the account’s investment
earnings. Any balance remaining at the end of a fiscal year must be
carried forward.
DMHAS must use the funds to provide opioid antagonists as
specified above, except the department may use up to 2% of the account
in any fiscal year for related administrative expenses.
EMS-Provided Opioid Antagonist Kits
Under the bill, EMS personnel must distribute opioid antagonist kits
with a personal supply of this medication and a one-page fact sheet to
patients who (1) they are treating for an opioid overdose, (2) show 2023SB-00009-R01-BA.DOCX
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symptoms of opioid use disorder, or (3) are treated at a location where
the personnel observe evidence of illicit use of opioids. The personnel
must give the kits to the patients themselves or their family members,
caregivers, or friends who are at the location.
The fact sheet must be the one that existing law requires the state’s
Alcohol and Drug Policy Council to develop, with information on the
risks of taking an opioid drug, symptoms of opioid use disorder, and
available in-state services for people who experience symptoms of, or
are otherwise affected by, opioid use disorder.
The bill requires the EMS personnel, as they find appropriate, to refer
the patient (or their family member, caregiver, or friend) to the written
instructions on administering the opioid antagonist.
For these purposes, EMS personnel include emergency medical
responders, emergency medical technicians (EMTs), advanced EMTs,
EMS instructors, and paramedics. The bill requires them to document
the number of kits they distribute through the program, including the
number of doses of opioid antagonists in each kit.
The bill allows EMS organizations to obtain opioid antagonists from
pharmacists to distribute through the program. The organizations may
obtain them, under existing procedures, through a (1) qualified
pharmacist’s prescription, (2) standing order, or (3) distribution
agreement with the pharmacist.
DPH’s Office of Emergency Medical Services Annual Report
Starting by January 1, 2025, the bill requires the executive director of
DPH’s Office of Emergency Medical Services to annually report to
DMHAS on the implementation of the above EMS-related provisions.
This includes any information known to the executive director that must
be included in the DMHAS substance use disorder plan under the bill
(see below).
State Substance Use Disorder Plan
By law, the DMHAS commissioner must (1) develop and implement
a comprehensive state substance use disorder plan and (2) update the 2023SB-00009-R01-BA.DOCX
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plan every three years. The bill requires her to include the following
information in the plan:
1. the amount of funds used to buy and distribute opioid
antagonists;
2. the number of eligible entities receiving opioid antagonists under
these provisions;
3. the amount of opioid antagonists purchased and, if known by
DMHAS, how the entities used them; and
4. any recommendations for the Bulk Purchase Fund, including
proposed legislation to facilitate the bill’s purposes.
§ 6 — ENCOURAGEMENT TO OBTAIN OPIOID ANTAGONIST
Requires prescribing practitioners, when prescribing an opioid, to encourage the patient
(and parents or guardian when applicable) to obtain an opioid antagonist
The bill requires prescribing practitioners, when prescribing an
opioid (whether to an adult or minor patient), to encourage the patient
to obtain an opioid antagonist. If the patient is a minor, the prescriber
must also encourage the patient’s custodial parent, guardian, or other
person with legal custody to obtain an opioid antagonist, if they are
present when the prescription is being issued.
EFFECTIVE DATE: October 1, 2023
§ 7 — SDE HEALTH CARE CAREER PROMOTION
Requires the education commissioner to use an existing plan to promote health care
careers and provide health care job shadowing and internship experiences; requires the
commissioner to give the plan to school boards and support its implementation
Existing law required OWS, in consultation with various
stakeholders, to develop a plan to work with high schools in the state to
encourage students to pursue high demand health care professions (e.g.,
nursing and behavioral and mental health care).
The bill requires the education commissioner, in collaboration with
the chief workforce officer, to use this plan in (1) promoting health care
professions as career options to middle and high school students and (2) 2023SB-00009-R01-BA.DOCX
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health care job shadowing and internship experiences for high school
students.
The commissioner must promote these professions through (1) career
day presentations; (2) developing partnerships with in-state health care
career education programs; and (3) creating counseling programs to
inform high school students about, and recruit them for, health care
professions.
By September 1, 2023, the education commissioner must (1) provide
the OWS plan to each local and regional school board and (2) through
the Governor’s Workforce Council Education Committee, support the
plan’s implementation.
EFFECTIVE DATE: July 1, 2023
§ 8 — HEALTH CARE WO RKFORCE WORKING GROU P
Requires OWS to convene a working group to develop recommendations to expand the
state’s health care workforce
The bill requires OWS to convene a working group to develop
recommendations for expanding the health care workforce in the state.
The group must evaluate:
1. the quality of in-state education and clinical training programs
for nurses and nurse’s aides;
2. the potential for increasing the number of these clinical training
sites;
3. the expansion of these clinical training facilities;
4. any barriers to recruit and retain health care providers, including
nurses and nurse’s aides;
5. the impact of the state health care staffing shortage on the
provision of health care services, the public’s access to these
services, and service wait times; and
6. the impact of federal and state reimbursement for the costs of 2023SB-00009-R01-BA.DOCX
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health care services on the public’s access to them.
EFFECTIVE DATE: Upon passage
Working Group Membership and Procedures
Under the bill, the working group consists of the following members:
1. two representatives of a labor organization representing acute
care hospital workers in the state;
2. two representatives of a labor organization representing nurses
and nurse’s aides employed by the state or an in-state hospital or
long-term care facility;
3. two representatives of a labor organization representing faculty
and professional staff at the regional community-technical
colleges;
4. the chairperson of the Board of Regents for Higher Education
(BOR) and the presidents of the Connecticut State Colleges and
Universities and UConn, or their designees;
5. one member of the UConn Health Center’s administration;
6. two representatives of the Connecticut Conference of
Independent Colleges;
7. the DPH, DSS, and Department of Administrative Services
commissioners, or their designees;
8. the Office of Policy and Management secretary, or his designee;
9. a representative of the State Board of Examiners for Nursing;
10. a representative of the State Employees Bargaining Coalition;
and
11. the chairpersons and ranking members of the Public Health and
Higher Education and Employment Advancement committees,
or their designees. 2023SB-00009-R01-BA.DOCX
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The bill requires the DPH commissioner and BOR chairperson, or
their designees, to serve as the working group’s chairpersons. They
must schedule the first meeting, to be held within 60 days after the bill’s
passage.
Reporting Requirement
The bill requires the working group to report to the Public Health and
Higher Education and Employment Advancement committees by
January 1, 2024. The group must report its findings and any
recommendations to improve recruiting and retaining health care
providers in the state, including a five-year and a 10-year plan to
increase the health care workforce in the state.
The group ends when it submits its report or January 1, 2024,
whichever is later.
§§ 9 & 10 — HEALTH CARE PROVIDERS SERVIN G AS ADJUNCT
FACULTY
Requires public higher education institutions to consider any licensed health care provider
with at least 10 years of clinical experience to be qualified for an adjunct faculty position;
correspondingly requires the Office of Higher Education, within available appropriations,
to establish a program providing incentive grants to these providers who become adjunct
professors
Beginning January 1, 2024, the bill requires public higher education
institutions to consider any licensed health care provider applying for
an adjunct faculty position in their field to be qualified if the provider
has at least 10 years of clinical experience. Under the bill, the institutions
must give them the same consideration as other qualified applicants
(presumably, as it relates to experience). Providers hired under this
provision who remain in the position for at least one academic year are
eligible for incentive grants (see below).
These provisions apply to UConn, the Connecticut State Universities,
the regional community-technical colleges, and Charter Oak State
College.
EFFECTIVE DATE: July 1, 2023
Grant Program 2023SB-00009-R01-BA.DOCX
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The bill requires OHE, by January 1, 2024, and within available
appropriations, to establish and administer a program giving $20,000
incentive grants to licensed health care providers accepting adjunct
professor positions under the provisions described above if they remain
in the position for at least one academic year. These providers are
eligible for another $20,000 grant if they remain in the position for at
least two academic years. OHE’s executive director must establish the
application process.
The bill requires the executive director, starting by January 1, 2025, to
annually report on the program to the Public Health Committee. The
director must report on:
1. the number and demographics of the adjunct professors who
applied for and received program grants,
2. which institutions employed them and the number and types of
classes they taught, and
3. any other information he considers pertinent.
§ 11 — PERSONAL CARE ATTENDANT CAREER PATHWAYS
PROGRAM
Requires DSS to establish a PCA career pathways program, including both basic skills
and specialized skills pathways, to improve PCAs’ quality of care and incentivize their
recruitment and retention in the state
The bill requires DSS, by January 1, 2024, to establish and administer
a career pathways program for personal care attendants (PCAs). The
program’s purpose is to improve PCAs’ quality of care and incentivize
their recruitment and retention in the state.
PCAs provide in-home and community-based personal care
assistance and other non-professional services to the elderly and people
with disabilities. The bill allows PCAs who are not employed by a
consumer (i.e., a person receiving services under a state-funded
program), but eligible for this employment, to participate in the career
pathways program after completing a DSS-developed orientation.
EFFECTIVE DATE: July 1, 2023 2023SB-00009-R01-BA.DOCX
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Program Objectives
The bill requires the program to include at least the following
objectives:
1. increasing PCAs’ retention and recruitment to maintain a stable
workforce for consumers, including by creating career pathways
that improve PCAs’ skill and knowledge and increase their
wages;
2. dignity in how PCAs provide care, and how consumers receive
it, through meaningful collaboration between them;
3. improving the quality of personal care assistance and the
consumers’ overall quality of life;
4. advancing equity in personal care assistance;
5. promoting a culturally and linguistically competent PCA
workforce to serve the growing racial, ethnic, and linguistic
diversity of an aging consumer population; and
6. promoting self-determination principles for PCAs.
Program Components
Under the bill, the DSS commissioner must offer the following
pathways under the program:
1. the basic skills career pathways, including general health and
safety and adult education topics; and
2. the specialized skills career pathways, including cognitive
impairments and behavioral health, complex physical care needs,
and transitioning to home- and community-based living from
out-of-home care or homelessness.
The commissioner must develop or identify the training curriculum
for each pathway. In doing so, she must consult with a hospital’s or
health care organization’s labor management committee. 2023SB-00009-R01-BA.DOCX
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Reporting Requirement
By January 1, 2025, the bill requires the commissioner to report to the
Human Services and Public Health committees on the following
program information:
1. the number of enrolled PCAs and the pathways they choose;
2. the number of PCAs who completed a career pathway, by
pathway type;
3. the program’s effectiveness, as determined by surveys, focus
groups, and interviews of PCAs, and whether completing the
program led to (a) a related license or certificate or (b) continued
employment for each PCA; and
4. the number of PCAs employed by consumers with specialized
care needs after completing a specialized career pathway and
whom the consumer kept employed for at least (a) six months
and (b) 12 months.
§ 12 — HOSPITAL PRIVILEGES
Prohibits hospitals, for purposes of granting practice privileges, from requiring (1) board
eligible physicians to become board certified until five years after becoming board eligible,
or (2) board certified physicians to provide credentials of board recertification
The bill prohibits hospitals (and their medical review committees),
for purposes of granting practice privileges, from requiring board
eligible physicians to become board certified until five years after
becoming board eligible. It also prohibits them, for purposes of granting
practice privileges or allowing a physician to retain those privileges,
from requiring board certified physicians to provide credentials of
board recertification.
Under the bill, a physician is “board eligible” after graduating from
medical school, completing a residency program, training under
supervision in a specialty fellowship program, and then being eligible
to take a medical specialty board’s qualifying examination. A physician
is “board certified” after passing such an exam to become board certified
in a particular specialty. 2023SB-00009-R01-BA.DOCX
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EFFECTIVE DATE: October 1, 2023
§§ 13-15 — PHYSICIAN, APRN, OR PA NON-COMPETE CLAUSES
Places additional limitations on physician non-compete clauses when the physician does
not agree to a material change to the employment contract; extends to APRN or PA non-
compete clauses the limitations that apply to physician non-compete clauses under
existing law and the bill
Existing law sets limits on physician non-compete agreements
(“covenants not to compete”), including that they may extend for no
more than one year and a 15-mile radius from the physician’s primary
practice site. The bill additionally provides that physician non-compete
agreements entered into, amended, extended, or renewed on or after
October 1, 2023, are unenforceable under the following conditions:
1. the physician does not agree to a proposed material change to the
terms of the employment contract or agreement (or similar
professional arrangement), before or when it is extended or
renewed; and
2. the contract or agreement expires and is not renewed by the
employer or the employer terminates the employment or
contractual relationship, unless the termination is for cause.
The bill also extends the law on physician non-compete clauses,
including the bill’s changes, to APRN or PA non-compete agreements
entered into, amended, extended, or renewed on or after October 1,
2023.
EFFECTIVE DATE: July 1, 2023
APRN or PA Non-Compete Agreements
Current law does not specifically limit APRN or PA non-compete
agreements. In practice, courts generally consider certain factors when
assessing whether a particular non-compete agreement is reasonable,
such as its duration and geographical scope.
The bill applies the same statutory conditions and limitations for
physician non-compete agreements (under existing law and the bill) to
APRN or PA non-compete clauses entered into, amended, extended, or 2023SB-00009-R01-BA.DOCX
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renewed on or after October 1, 2023.
Definitions. The bill defines “covenant not to compete” for APRNs
and PAs in a way that is substantially similar to the definition in existing
law that applies to physicians. Under the bill, an APRN or PA “covenant
not to compete” is any provision of an employment or other contract or
agreement that establishes a professional relationship with an APRN or
PA, respectively, and restricts their right to practice in any area of the
state for any period after the end of the partnership, employment, or
other professional relationship.
Conditions and Limitations. Under the bill, an APRN or PA
covenant not to compete is valid and enforceable only if it is:
1. necessary to protect a legitimate business interest;
2. reasonably limited in time, geographic scope, and practice
restrictions as needed to protect that interest; and
3. otherwise consistent with the law and public policy. (These
factors are similar to those under the common law.)
The bill specifically prohibits these covenants from restricting an
APRN’s or PA’s competitive activities for longer than one year and
beyond 15 miles from the primary site where the APRN or PA practices.
The bill further provides that these covenants are unenforceable
against the APRN or PA if the:
1. employer terminates the employment or contractual relationship
without cause or
2. employment contract or agreement was not made in anticipation
of, or as part of, a partnership or ownership agreement and the
contract or agreement expires and is not renewed, unless before
the expiration the employer made a bona fide offer to renew the
contract on the same or similar terms.
It also provides that these agreements are unenforceable against the 2023SB-00009-R01-BA.DOCX
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provider if:
1. the APRN or PA does not agree to a proposed material change to
the terms of the employment contract or agreement (or similar
professional arrangement) before or when it is extended or
renewed; and
2. the contract or agreement expires and is not renewed by the
employer or the employer terminates the employment or
contractual relationship, unless the termination is for cause.
Under the bill, each covenant must be separately and individually
signed by the APRN or PA.
Other Contract Provisions and Burden of Proof. If a covenant is
rendered void and unenforceable under the bill, the remaining
provisions of the contract remain in full force and effect. This includes
provisions requiring the payment of damages for injuries suffered due
to the contract’s termination.
The bill specifies that the party seeking to enforce an APRN or PA
covenant not to compete bears the burden of proof at any proceeding.
§ 16 — PHYSICAL THERAPY LICENSURE COMPA CT
Enters Connecticut into the Physical Therapy Licensure Compact, which provides a
process authorizing physical therapists or physical therapy assistants properly
credentialed in one member state to practice across state boundaries, without requiring
licensure in each state
The bill enters Connecticut into the Physical Therapy Licensure
Compact. The compact creates a process authorizing physical therapists
(PTs) and PT assistants who are licensed or certified (as appropriate) in
one member state to practice across state boundaries without requiring
licensure or certification in each state. Member states must grant the
“compact privilege” (i.e., the authority to practice in the state) to people
holding a valid, unencumbered license who otherwise meet the
compact’s eligibility requirements. The compact is administered by the
PT Compact Commission, which Connecticut would join under the bill.
Among various other provisions, the compact: 2023SB-00009-R01-BA.DOCX
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1. sets eligibility criteria for states to join the compact and for PTs
or PT assistants to practice under it;
2. addresses several matters related to disciplinary actions for
licensees practicing under the compact, such as information
sharing among member states and removal of compact
privileges;
3. provides that amendments to the compact only take effect if all
member states adopt them into law; and
4. has a process for states to withdraw from the compact.
A broad overview of the compact appears below.
EFFECTIVE DATE: July 1, 2023
Compact Overview
The PT Compact creates a process authorizing PTs and PT assistants
to work in multiple states if they are licensed (for PTs) or licensed or
certified (for assistants) in one member state. A “licensee” is someone
currently authorized by a state to practice as a PT or PT assistant.
Under the compact, a “state” is a U.S. state, commonwealth, district,
or territory that regulates physical therapy. A “member state” is a state
that has joined the compact.
A “home state” is the member state that is the licensee’s primary state
of residence. A “remote state” is a member state, other than the home
state, where a licensee is exercising or seeking to exercise the compact
privilege.
The compact allows active-duty military personnel, or their spouses,
to designate as their home state their (1) home of record, (2) permanent
change of station, or (3) state of current residence if different from either
of those.
“Compact privilege” is a remote state’s authorization to allow a
licensee from another member state to practice in the remote state under 2023SB-00009-R01-BA.DOCX
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its laws and rules. The compact specifies that PT practice occurs in the
member state where the patient or client is located.
State Eligibility (§ 16(3))
To participate in the compact, a state must do the following:
1. participate fully in the commission’s licensee data system,
including using the commission’s unique identifier;
2. have a mechanism to receive and investigate complaints about
licensees;
3. notify the commission, in compliance with the compact’s terms
and rules, about any adverse action (i.e., board disciplinary
action for misconduct or unacceptable performance) or the
availability of investigative information about a licensee;
4. fully implement a criminal background check requirement,
within deadlines set by rule, by receiving FBI search results and
using that information in making licensure decisions (see below
and § 17);
5. comply with the commission’s rules;
6. require passage of a recognized national examination for
licensure, under the commission’s rules; and
7. require continuing competence (e.g., continuing education) for
license renewal.
Upon joining the compact, member states must have the authority to
get biometric-based information from each PT licensure applicant and
submit it to the FBI for a criminal record check.
Individual Compact Privilege (§ 16(3) & (4))
The compact requires member states to grant the compact privilege
to a licensee holding a valid, unencumbered license in another member
state, under the compact’s terms and rules. Member states may charge
a fee for granting the privilege. 2023SB-00009-R01-BA.DOCX
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To exercise the compact privilege, a licensee must meet the following
requirements:
1. be licensed in the home state;
2. have no encumbrance on any state license;
3. be eligible for a compact privilege in any member state, under the
compact’s provisions on remote states’ authority to remove that
privilege (see next subheading);
4. have no adverse action against any license or compact privilege
within the prior two years;
5. notify the commission that the licensee is seeking the compact
privilege in one or more remote states;
6. pay any state fees or other applicable fees for the compact
privilege;
7. meet any applicable remote states’ jurisprudence requirements
(i.e., assessment of knowledge of PT practice laws and rules for
that state); and
8. report to the commission within 30 days after being subject to
adverse action by any non-member state.
Under the compact, the privilege is valid until the home license
expires. The licensee must comply with the above requirements to
maintain the privilege in the remote state.
Respective States’ Authority, Adverse Actions, and Data System
(§ 16(4), (6) & (8))
The compact addresses several matters related to states’ authority to
investigate and discipline licensees practicing under its procedures.
Broadly, the compact maintains the home state authority to regulate the
home state license and grants the remote state the authority to regulate
the compact privilege in that state, each according to its own regulatory
structure. Additionally, a home state may take action against a licensee 2023SB-00009-R01-BA.DOCX
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based on investigative information from a remote state.
The following are examples of the regulatory structure under the
compact:
1. a home state has exclusive authority to impose adverse action
against a home state license, but a remote state may remove a
licensee’s compact privilege, investigate and issue subpoenas,
impose fines, and take other necessary action;
2. if allowed by their law, remote states may recover from the
licensee any investigation and disposition costs for cases leading
to adverse actions;
3. if a licensee’s home state license is encumbered or remote state
privilege is removed, he or she cannot regain the compact
privilege in any remote state until (a) the encumbrance is lifted
or removal period passes; (b) two years have passed since the
adverse action; (c) for remote state removals, any fines have been
paid; and (d) the licensee otherwise meets the compact’s
eligibility requirements;
4. member states may allow licensees to participate in an alternative
program (e.g., for substance abuse) rather than imposing an
adverse action, but the state must require the licensee to get prior
authorization from other member states before practicing there
during this period; and
5. any member state may investigate actual or alleged violations in
other member states where a licensee holds a license or compact
privilege.
Member states must submit the same information on licensees for
inclusion in a database the compact creates, and the commission must
promptly notify all member states about any adverse action against
licensees or licensure applicants. Investigation information about a
licensee is available only to states in which a licensee holds, or is
applying for, a license or compact privilege. 2023SB-00009-R01-BA.DOCX
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PT Compact Commission (§ 16(7) & (9))
The compact is administered by the PT Compact Commission, which
consists of one voting member appointed by each member state’s PT
licensing board. The compact sets forth several powers, duties, and
procedures for the commission. For example, the commission:
1. may make rules to facilitate and coordinate the compact’s
implementation and administration (a rule has no effect if a
majority of the member states’ legislatures reject it within four
years of the rule’s adoption),
2. may levy and collect an annual assessment from each member
state and impose fees on other parties to cover the costs of its
operations, and
3. must have its receipts and disbursements audited yearly and the
audit report included in the commission’s annual report.
The compact addresses several other matters regarding the
commission and its operations, such as setting conditions under which
its officers and employees are immune from civil liability. By virtue of
adopting the compact, Connecticut joins the commission.
Compact Oversight, Enforcement, Member Withdrawal, and
Related Matters (§ 16(10)-(12))
Among other related provisions, the compact provides the following:
1. each member state’s executive, legislative, and judicial branches
must enforce the compact and take necessary steps to carry out
its purposes;
2. the commission must take specified steps if a member state
defaults on its obligations under the compact, and after all other
means of securing compliance have been exhausted, a defaulting
state is terminated from the compact upon a majority vote of the
member states;
3. upon a member state’s request, the commission must attempt to
resolve a compact-related dispute among member states or 2023SB-00009-R01-BA.DOCX
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between member and non-member states;
4. the commission must enforce the compact and rules and may
bring legal action against a member state in default upon a
majority vote (the case may be brought in the U.S. District Court
for the District of Columbia or the federal district where the
commission’s principal offices are located);
5. a member state may withdraw from the compact by repealing
that state’s enabling legislation, but withdrawal does not take
effect until six months after the repealing statute’s enactment;
6. the member states may amend the compact, but no amendment
takes effect until all member states enact it into law; and
7. the compact’s provisions are severable and its provisions must be
liberally construed to carry out its purposes, and if the compact
is held to violate a member state’s constitution, it remains in
effect in the remaining member states.
§ 17 — BACKGROUND CH ECKS FOR PT AND PT A SSISTANT
LICENSURE
Requires PT and PT assistant licensure applicants to complete a fingerprint-based
criminal background check
Under the bill, the DPH commissioner must require anyone applying
for PT or PT assistant licensure to submit to a state and national
fingerprint-based criminal history records check by the Department of
Emergency Services and Public Protection (DESPP).
EFFECTIVE DATE: July 1, 2023
§ 18 — PODIATRIC SCOPE OF PRACTICE WORKI NG GROUP
Requires DPH to establish a working group to advise the department and any relevant
scope of practice review committee on podiatrists’ scope of practice relating to surgical
procedures
The bill requires the DPH commissioner to establish a working group
to advise DPH and any relevant scope of practice review committee (see
below) on podiatrists’ scope of practice relating to surgical procedures.
The commissioner appoints the working group’s members, which must 2023SB-00009-R01-BA.DOCX
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include at least three podiatrists and three orthopedic surgeons.
By January 1, 2024, the working group must report its findings and
recommendations to the commissioner and any such scope of practice
review committee. By February 1, 2024, the commissioner must report
to the Public Health Committee on (1) the group’s findings and
recommendations and (2) whether DPH and any relevant scope of
practice review committee agrees with them.
Existing law has a process for DPH to review requests from
representatives of health care professions seeking to establish or revise
a scope of practice before consideration by the legislature. DPH selects
the requests it will act upon and, within available appropriations,
appoints members to scope of practice review committees, whose
members include representatives from the profession making the
request and other professions directly impacted by it (CGS § 19a-16e).
EFFECTIVE DATE: July 1, 2023
§§ 19 & 20 — APRN LICENSURE BY ENDORSEME NT AND
INDEPENDENT PRACTICE
Allows for licensure by endorsement for APRNs who have (1) practiced for at least three
years in another state with practice requirements that are substantially similar to, or
higher than, Connecticut’s and (2) no disciplinary history or unresolved complaints
pending; correspondingly allows these APRNs to count their out-of-state practice toward
the existing requirement of three years’ practice in collaboration with a physician before
practicing independently
The bill allows APRNs with certain experience who are not otherwise
eligible to apply for licensure in Connecticut to apply for licensure by
endorsement. To be eligible, the applicant must give DPH satisfactory
evidence that he or she has (1) practiced for at least three years as an
APRN (or similar services under a different designation) in another state
or jurisdiction and (2) no disciplinary actions or unresolved complaints
pending. The other jurisdiction must have requirements for practicing
that are substantially similar to, or higher than, Connecticut’s.
The bill requires these applicants to pay a $200 fee, the same as for
other APRN licensure applicants under existing law.
Under current law, APRNs must practice in collaboration with a 2023SB-00009-R01-BA.DOCX
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physician for the first three years after becoming licensed in the state.
They may practice without this collaboration if they have been licensed
and practicing in collaboration with a physician for at least three years
with at least 2,000 hours of practice. The bill allows APRNs who are
licensed by endorsement under the above procedures to count their
prior out-of-state practice toward this three-year requirement, if that
practice was under collaboration with a physician licensed in another
state and otherwise meet existing law’s requirements. APRNs who meet
these requirements may practice independently.
EFFECTIVE DATE: October 1, 2023
§ 21 — SPLASH PAD AND SPRAY PARK WARNING SIGNS
Requires splash pad and spray park owners or operators to post warning signs about the
potential health risk of ingesting recirculated water
The bill requires owners or operators of splash pads and spray parks
where water is recirculated to post a sign stating that the water is
recirculated and warning of the potential health risk to people ingesting
it. They must post the sign by January 1, 2024, and in a conspicuous
place at or near the entrance.
EFFECTIVE DATE: July 1, 2023
§ 22 — LPN EDUCATION PILOT PROGRAM
Allows the state nursing board, under certain conditions, to approve applications from
higher education institutions to create a pilot program for licensed practice nurse
education and training, and grants the program full approval if it meets specified
requirements for two years
The bill allows certain public or independent higher education
institutions, by January 30, 2024, to apply to the State Board of
Examiners for Nursing to create a pilot program offering licensed
practical nursing (LPN) education and training. To be eligible, the
institution must (1) maintain accreditation as a degree-granting
institution in good standing by a regional accrediting association
recognized by the federal Department of Education and (2) offer, or be
seeking state approval to offer, a nursing program approved by the state
Office of Higher Education.
Under the bill, a higher education institution that applies to the 2023SB-00009-R01-BA.DOCX
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nursing board to establish a pilot program must give the board the
following information in writing, at least 60 days before the proposed
program state date:
1. identifying information about the pilot program, including its
name, address, contact information, and responsible party;
2. a program description, including accreditation status, any clinical
partner, and anticipated enrollment by academic term;
3. identified resources to support the program;
4. graduation rates and National Council Licensure Examination
licensure and certification pass rates for the past three years for
any existing nursing programs the institution offers;
5. a plan for employing qualified faculty and administrators and
clinical experiences; and
6. other information as the board requests.
If the institution gives this information, the nursing board must
review and consider the program application. The board may hold a
public hearing on it.
Under the bill, the pilot program must comply with relevant
provisions of the state’s Nurse Practice Act (chapter 378) and specified
regulations on nursing education programs. The pilot program is
deemed fully approved by the nursing board if it (1) meets these
requirements for two years and (2) provides evidence that the program
is meeting its education outcomes as shown by an acceptable level of
graduates’ performance, as defined in state regulation (e.g., an average
passage rate of 80% for first-time takers of the required licensure
examination).
EFFECTIVE DATE: Upon passage
§ 23 — RECIPROCITY AGREEMENTS FOR CLIN ICAL ROTATION
TRAINING 2023SB-00009-R01-BA.DOCX
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Allows OHE to enter into a reciprocity agreement with neighboring states regarding
clinical training credit at higher education institutions
The bill allows OHE to enter into a reciprocity agreement with one or
more neighboring states regarding clinical training credit at higher
education institutions. Under the agreement, the other state could allow
students attending a higher education institution in that state to train in
a clinical rotation for credit in Connecticut, as long as the state also
allows a student attending a Connecticut higher education institution to
train in a clinical rotation for credit in the other state.
EFFECTIVE DATE: Upon passage
§ 24 — COMMISSION ON COMMUNITY GUN VIOLE NCE
INTERVENTION AND PREVENTION
Specifically allows the Commission on Community Gun Violence Intervention and
Prevention to create a subcommission, an advisory group, or another entity for specified
purposes related to providing home health care and services to people affected by gun
violence
PA 22-118 established a Commission on Community Gun Violence
Intervention and Prevention to advise the DPH commissioner on
developing evidence-based, evidenced-informed, community-centric
gun programs and strategies to reduce community gun violence in the
state.
The law allows the commission to establish subcommissions,
advisory groups, or other entities it deems necessary to further its
purposes. The bill specifically allows the commission to establish such
an entity to evaluate the (1) challenges associated with providing home
health care to victims of gun violence and (2) ways to foster a system
uniting community service providers with adults and juveniles needing
supports and services to address trauma due to gun violence.
EFFECTIVE DATE: July 1, 2023
§§ 25 & 26 — MATERNAL MENTAL HEALTH TOOL KIT AND
PERINATAL MOOD AND A NXIETY DISORDER TRAINING
Requires DPH, in consultation with DMHAS and certain other organizations, to develop
a maternal mental health toolkit for providers and patients, including on perinatal mood
and anxiety disorders; requires hospitals to include training in perinatal mood and
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The bill requires DPH to develop a toolkit to give information and
resources on maternal mental health to licensed health care
professionals and new parents in the state. In doing so, DPH must
consult with DMHAS and organizations representing health care
facilities and licensed health care professionals.
The toolkit must at least include (1) information about perinatal
mood and anxiety disorders (see Background), including their
symptoms, potential impact on families, and treatment options; and (2)
a list of licensed health care professionals, peer support networks, and
nonprofit organizations in the state that treat these disorders or provide
related support for patients and their family members. By October 1,
2023, DPH must make the toolkit available on its website.
Starting October 1, 2023, the bill also requires hospitals to include
training in perinatal mood and anxiety disorders as part of their regular
training to staff members who directly care for women who are
pregnant or in the postpartum period.
EFFECTIVE DATE: Upon passage, except October 1, 2023, for the
hospital training provision.
Background — Perinatal Mood and Anxiety Disorders
Generally, perinatal mood and anxiety disorders refer to a range of
symptoms that may occur during pregnancy and the post-partum
period, such as depression and anxiety, or in rare cases, post-partum
psychosis.
Background — Related Bill
SB 1160 (File 177), reported favorably by the Public Health
Committee, contains identical provisions on a maternal mental health
toolkit and hospital training.
§ 27 — EMERGENCY DEP ARTMENT CROWDING WO RKING
GROUP
Requires the DPH commissioner to convene a working group to advise her on how to
alleviate emergency department crowding and the lack of available beds
The bill requires the DPH commissioner, by July 1, 2023, to convene 2023SB-00009-R01-BA.DOCX
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a working group to advise her on ways to ease emergency department
(ED) crowding and lack of available ED beds in the state. Specifically,
the group must advise on:
1. setting a quality measure for the timeliness of transferring
patients from the ED to hospital admission;
2. establishing ED discharge units to expedite the discharge process;
3. evaluating the percentage of ED patients held in the department
after admission and while waiting for an inpatient bed, and
making a plan to lower it; and
4. reducing liability for hospitals and their emergency physicians
when ED crowding causes significant wait times for patients
seeking these services.
EFFECTIVE DATE: Upon passage
Working Group Membership and Procedures
Under the bill, the working group may consist of following members,
among others:
1. two emergency physicians representing the state chapter of a
national college of emergency physicians;
2. two emergency physicians who are ED directors, one from a
larger hospital system in the state and the other from an
independent community hospital;
3. a primary care physician representing the state chapter of a
national college of physicians;
4. two representatives of an in-state hospital association;
5. a representative of an in-state medical society;
6. a representative of the state chapter of a national organization of
emergency nurses; 2023SB-00009-R01-BA.DOCX
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7. a representative of the state chapter of a national organization of
pediatric physicians;
8. a representative of the state chapter of a national association of
psychiatrists;
9. a representative of an in-state association of nurses;
10. two nurses who are ED nurse directors, one from a larger hospital
system and the other from an independent community hospital;
11. two patient care navigators, one who works for a larger hospital
system and the other for an independent community hospital;
12. a representative of hospital patients in the state;
13. a provider of emergency medical transportation services in the
state;
14. a representative of a national association of retired people;
15. the state healthcare advocate, child advocate, DMHAS
commissioner, and Department of Children and Families (DCF)
commissioners, or their designees;
16. two DPH representatives, one from the Office of Emergency
Medical Services and one from the department’s facilities
licensing and investigations section;
17. a representative of the Office of the Long-Term Care
Ombudsman;
18. two representatives from in-state nursing homes, one from a for-
profit and the other from a nonprofit;
19. one representative from the insurance industry in the state; and
20. one member of an association of trial lawyers in the state.
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chairpersons, who must be (1) one of the emergency physicians
representing the state chapter of a national college of emergency
physicians and (2) one of the representatives of an in-state hospital
association.
Under the bill, the working group’s first meeting must be held by
December 1, 2023. The chairpersons may hold the first meeting even if
the DPH commissioner has not yet selected all members. If the
commissioner has not selected a member by August 1, 2023, the
chairpersons may jointly select the member.
The group must meet twice a year and at other times upon the
chairpersons’ call.
Reporting Requirement
The bill requires the working group to report its findings and
recommendations by January 1, 2024, and by January 1, 2025, to the
DPH commissioner and Public Health Committee.
Background — Related Bill
sSB 960 (File 101), reported favorably by the Public Health
Committee, has similar provisions on an ED crowding working group.
§ 28 — PSYCHOSIS TASK FORCE
Creates a task force to study childhood and adult psychosis
The bill creates a 10-member task force to study childhood and adult
psychosis. The study must examine the following:
1. in collaboration with DCF and DMHAS, establishing clinics
staffed by mental health care providers in various fields who
provide comprehensive care for children and adults experiencing
early or first episode psychosis, to prevent the symptoms from
becoming disabling;
2. early evaluation of children and adults with psychosis symptoms
and management of these symptoms, including starting treatment
and making necessary referrals for additional treatment or
services; 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 36 5/26/23
3. creating care pathways that include specialty teams that treat
children and adults experiencing early or first episode psychosis;
4. creating a statewide model for coordinating specialty care for
children and adults experiencing psychosis, as recommended by
the National Institute of Mental Health;
5. creating services for these children and adults, including
collaboration on psychotherapy and pharmacotherapy, family
support, education, coordination with community support
services, and collaboration with employers and education
systems; and
6. strengthening existing clinical networks that treat people
experiencing psychosis, with a focus on collaborative research
and outcomes.
Under the bill, “psychosis” is a severe mental condition in which
disruptions to thoughts and perceptions make it difficult for a person to
recognize what is real and what is not, with these disruptions often
experienced as seeing, hearing, and believing things that are not real or
having strange, persistent thoughts, behaviors, and emotions, including
hallucinations and delusions.
EFFECTIVE DATE: Upon passage
Membership and Administration
Under the bill, the task force includes the DMHAS and DCF
commissioners, or their designees, and eight appointed members, as
shown in the table below.
Table: Psychosis Task Force Appointed Members
Appointing Authority Appointee Qualifications
House speaker (2) A child and adolescent psychiatrist with experience
treating patients with psychosis
A clinical researcher in the field of psychosis
Senate president pro
tempore (2)
A psychiatrist with experience treating adults with
psychosis 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 37 5/26/23
A clinical researcher in the field of psychosis
House majority leader (1) A parent or guardian of a child or adolescent
treated for psychosis
Senate majority leader (1) An adult treated for psychosis
House minority leader (1) A licensed mental health care provider who has
treated children or adolescents with psychosis
Senate minority leader (1) A licensed mental health care provider who has
treated adults with psychosis
Under the bill, legislative appointees may be legislators. Initial
appointments must be made within 30 days after the bill’s passage.
Appointing authorities fill any vacancy.
The House speaker and Senate president pro tempore select the task
force chairpersons from among its members. The chairpersons must
schedule the first meeting, to be held within 60 days after the bill’s
passage.
The Public Health Committee’s administrative staff serves in that
capacity for the task force.
Reporting Requirement
The bill requires the task force to report its findings and
recommendations to the Public Health Committee by January 1, 2024.
The task force terminates when it submits the report or on January 1,
2024, whichever is later.
Background — Related Bill
sSB 919 (File 65), reported favorably by the Public Health Committee,
contains identical provisions on a psychosis task force.
§§ 29-34 — EVALUATIONS AND REPORTS RELAT ED TO
PARENTING AND SUBSTA NCE USE DISORDER
Requires DMHAS, DCF, and certain other state agencies to evaluate or report on various
supports and related issues for parents, other child caregivers, or pregnant individuals
with substance use disorder
The bill requires various state agencies to evaluate or report on
supports, programs, and related issues for parents, other child
caregivers, or pregnant individuals with substance use disorder. 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 38 5/26/23
EFFECTIVE DATE: Upon passage
Child Caregiver Substance Use Disorder Program Plan (§ 29)
The bill requires DMHAS, DCF, and DSS to evaluate substance use
disorder programs for people who are child caregivers and related
treatment barriers. In doing the evaluation, the departments must
consult with direct service providers and people with lived experience.
In consultation with these providers and people, the departments
must also make a plan to establish and implement programs to treat
these child caregivers and their children, that include the following:
1. in all geographic areas, same-day access to family-centered
medication-assisted treatment, including prenatal and perinatal
care, and access to supports that provide a bridge to the
treatment;
2. intensive in-home treatment supports;
3. gender-specific programming;
4. expanded access to residential programs for pregnant and
parenting people, including residential programs for parents
who have more than one child or who have children over age
seven; and
5. access to recovery support specialists and peer support to
provide care coordination.
The bill requires the commissioners, by January 1, 2024, to jointly
report to the Children’s, Human Services, and Public Health committees
on the plan and legislative recommendations needed to implement the
programs.
Child Care Supports and Subsidies Plan (§ 30)
The bill requires DMHAS and DSS to collaborate with the Office of
Early Childhood and create a plan to allow parents in substance use
disorder treatment to qualify for child care supports and subsidies. The
DMHAS and DSS commissioners must jointly report on the plan to the
Human Services and Public Health committees by January 1, 2024. 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 39 5/26/23
Supportive Housing Access (§ 31)
The bill requires the DMHAS commissioner to report to the Housing,
Human Services, and Public Health committees by January 1, 2024, on
access in the state to supportive housing for pregnant and parenting
people with a substance use disorder.
Substance Use Disorder Treatment for Parents Involved with DCF
(§ 32)
The bill requires the DCF, DMHAS, and DSS commissioners to jointly
report on access for parents involved with DCF, when applicable, to
appropriate substance use disorder treatment in the state, to (1) prevent
children’s removal from their parents, when possible, and (2) support
reunification when removal is necessary. The report must consider in-
home parenting and child care services to help with safety planning
during initial stages of treatment and recovery.
The commissioners must report to the Children’s, Human Services,
and Public Health committees by January 1, 2024.
Services For Pregnant and Parenting Individuals (§ 33)
The bill requires the DCF, DMHAS, and DSS commissioners to jointly
report on existing substance use disorder treatment services for
pregnant and parenting people, their use, and any areas where more
services are necessary. The commissioners must report to the Public
Health Committee by January 1, 2024.
Mitigating Safety Concerns for Children Whose Caregivers Have
Substance Use Disorder (§ 34)
The bill requires the DCF commissioner, by January 1, 2024, to report
to the Children’s and Public Health committees on DCF’s efforts to
mitigate child safety concerns in the home when the child’s caregiver
has a substance use disorder.
Background — Related Bill
sHB 6913 (File 595, §§ 5-10), reported favorably by the Public Health
Committee, contains similar provisions requiring plans or evaluations
related to supports for parents, other child caregivers, or pregnant
individuals with substance use disorder. 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 40 5/26/23
§ 35 — OPIOID SETTLEMENT FUND ADVISORY C OMMITTEE
Adds eight members to the Opioid Settlement Fund Advisory Committee
The bill increases, from 37 to 45, the membership of the Opioid
Settlement Fund Advisory Committee. It does so by (1) increasing the
number of governor-appointed municipal representatives from 17 to 21;
(2) adding two members with experience supporting infants and
children affected by the opioid crisis, appointed by the DMHAS
commissioner; and (3) adding the Public Health Committee
chairpersons or their designees (the designees must have experience
living with a substance use disorder or have a family member with such
a disorder).
By law, the committee ensures (1) Opioid Settlement Fund moneys
are allocated and spent on specified substance use disorder abatement
purposes and (2) robust public involvement, accountability, and
transparency in allocating and accounting for the fund’s moneys.
EFFECTIVE DATE: July 1, 2023
Background — Related Bill
sHB 6913 (File 595, § 11), reported favorably by the Public Health
Committee, adds to the committee two members with experience
supporting infants and children affected by the opioid crisis.
§ 36 — EMS DATA COLLECTION AND REPORTING
Requires EMS organizations, in their quarterly data reporting, to include the reasons for
9-1-1 calls; requires the DPH commissioner to annually submit EMS data to the Public
Health Committee and expands the reporting requirements to include data on EMS
personnel shortages
Current law requires EMS organizations to report to DPH quarterly
on specified EMS call data, including the number of 9-1-1 calls received.
The bill requires organizations to also report the reasons for the calls.
Under existing law, unchanged by the bill, EMS organizations must also
report the (1) level of EMS required for each call; (2) response time; (3)
number of passed, cancelled, and mutual aid calls made and received;
and (4) prehospital data for unscheduled patient transport.
By law, DPH must annually report on the data it collects to the EMS 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 41 5/26/23
Advisory Board. The bill adds data on any EMS personnel shortages in
the state to this reporting requirement. Starting by June 1, 2024, the bill
requires the commissioner to annually submit the report to the Public
Health Committee, as well.
EFFECTIVE DATE: October 1, 2023
Background — Related Bill
HB 1229 (File 573), reported favorably by the Public Health
Committee, has similar provisions on EMS data collection and
reporting.
§ 37 — RURAL HEALTH TASK FORCE
Creates a task force to study issues concerning rural health
The bill creates a task force to study issues concerning rural health.
The study must examine (1) resources and services available to promote
rural health and support health care providers in rural areas throughout
the state and (2) ways to coordinate and streamline these resources and
services.
EFFECTIVE DATE: Upon passage
Membership and Administration
Under the bill, the task force includes the DPH and DMHAS
commissioners, attorney general, state comptroller, and Office of Health
Strategy executive director or their designees and 10 appointed
members, one each appointed by the six legislative leaders and the
Public Health Committee chairpersons and ranking members.
Under the bill, legislative appointees may be legislators. Initial
appointments must be made within 30 days after the bill’s passage.
Appointing authorities fill any vacancy.
The House speaker and Senate president pro tempore select the task
force chairpersons from among its members. The chairpersons must
schedule the first meeting, to be held within 60 days after the bill’s
passage. 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 42 5/26/23
The Public Health Committee’s administrative staff serves in that
capacity for the task force.
Reporting Requirement
The bill requires the task force to report its findings and
recommendations to the Public Health Committee by January 1, 2024.
The task force terminates when it submits the report or on January 1,
2024, whichever is later.
Background — Related Bill
sSB 1210 (File 524), reported favorably by the Public Health
Committee, has similar provisions on a rural health task force.
§ 38 — HEALTH CARE MAGNET SCHOOL STUDY
Requires the education commissioner, in consultation with the labor and DPH
commissioners, to study the feasibility of establishing an interdistrict magnet school
program focused on training students for health care professions
The bill requires the education commissioner, in consultation with
the labor and DPH commissioners, to study the feasibility of creating an
interdistrict magnet school program to educate and train students
interested in health care professions. This must include pathways for
students to (1) graduate with a certification, license, or registration
allowing them to practice in a health care field and (2) complete a
curriculum designed to prepare them for pre-medicine or nursing
higher education programs.
By February 1, 2024, the education commissioner must report on the
study to the Public Health Committee.
EFFECTIVE DATE: Upon passage
Background — Related Bill
sSB 1228 (File 524, § 1), reported favorably by the Public Health
Committee, has identical provisions on an interdistrict magnet school
program.
§ 39 — DELETED BY SENATE AMENDMENT “C”
§ 40 — COMMUNICATION ACCESS STUDY 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 43 5/26/23
Requires the aging and disability services commissioner, in consultation with the
Advisory Board for Persons Who are Deaf, Hard of Hearing or Deafblind, to evaluate gaps
in these individuals’ access to communication with medical providers
The bill requires the aging and disability services commissioner, in
consultation with the Advisory Board for Persons Who are Deaf, Hard
of Hearing or Deafblind, to (1) conduct a study evaluating gaps in these
individuals’ access to communication with medical providers and (2)
develop recommendations to improve t his access, including
interpreting through American Sign Language or Spanish Sign
Language as applicable. By October 1, 2023, the commissioner must
report on the study to the Aging, Human Services, and Public Health
committees.
EFFECTIVE DATE: Upon passage
Background — Related Bill
sSB 1228 (File 471, § 6), reported favorably by the Public Health
Committee, has similar provisions on a communication access study.
§§ 41 & 42 — DENTAL ASSISTANTS
Provides an alternate way for dental assistants to qualify to take dental x-rays, by passing
a competency assessment rather than a national exam, and requires UConn’s School of
Dental Medicine to develop the assessment by January 1, 2025
Existing law allows dentists to delegate certain procedures to dental
assistants if they are performed under the dentist’s direct supervision.
Under current law, these include dental x-rays, but only if the assistant
has passed the Dental Assisting National Board’s dental radiation health
and safety exam.
The bill allows dentists to also delegate these procedures to dental
assistants who have passed a radiation health and safety competency
assessment. That assessment must be administered by an in-state dental
education program accredited by the American Dental Association’s
Commission on Dental Accreditation.
By January 1, 2025, the bill requires UConn’s School of Dental
Medicine to (1) develop this competency assessment, reflecting current
industry practices on dental x-rays, and (2) report on its development to
the Public Health Committee. 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 44 5/26/23
EFFECTIVE DATE: Upon passage, except October 1, 2023, for the
provision on dental assistants’ eligibility to take dental x-rays after
passing the assessment.
Background — Related Bill
sSB 1228 (File 471, §§ 7 & 8), reported favorably by the Public Health
Committee, has identical provisions on dental assistants and the
UConn-developed assessment.
§ 43 — EPINEPHRINE ADMINISTRATION BY EMS PERSONNEL
Requires EMS personnel, under specified conditions, to administer epinephrine using
automatic prefilled cartridge injectors, similar automatic injectable equipment, or prefilled
vials and syringes
The bill requires EMS personnel to administer epinephrine using
automatic prefilled cartridge injectors, similar automatic injectable
equipment, or prefilled vials and syringes when the following
conditions are met:
1. the EMS professional has been trained to do so in accordance
with DPH-recognized national standards;
2. the medication is administered according to written protocols
and standing orders of a licensed physician serving as an
emergency department director; and
3. the EMS professional determines administering epinephrine is
necessary to treat the person.
Current law allows, but does not require, EMTs and paramedics to
do this using automatic prefilled cartridge injectors or similar
equipment.
The bill requires all EMS personnel to receive this training from a
DPH-designated organization; current law requires EMTs and
paramedics to receive this training.
Current law requires licensed or certified ambulances to have
epinephrine in injectors or equipment for administration. The bill
requires them to have epinephrine in injectors, similar equipment, or 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 45 5/26/23
prefilled vials and syringes for this purpose.
Under the bill, “EMS personnel” include EMTs, advanced EMTs,
paramedics, and emergency medical responders.
EFFECTIVE DATE: October 1, 2023
Background — Related Bill
SB 1073 (File 558, § 1), reported favorably by the Public Health
Committee, has similar provisions on the administration of epinephrine
by EMS personnel.
§ 44 — MEDICAL RECORDS REQUESTS
Generally sets deadlines for licensed health care institutions to send electronic copies of
patient medical records to another institution upon request
The bill sets deadlines for licensed health care institutions to transfer
an electronic copy of a patient’s medical records to another institution
upon receiving a medical records request directed by the patient or
patient’s representative. Under the bill, the transfer must occur (1) as
soon as feasible, but no later than six days, for urgent requests, or (2)
within seven business days, for non-urgent requests. The bill specifies
that the institution is not required to get specific written consent from
the patient before sending the electronic copy.
The bill exempts from these requirements (1) DMHAS-operated
facilities and (2) the hospital and psychiatric residential treatment
facility units of the Albert J. Solnit Children’s Center.
The bill also specifies that these provisions do not require institutions
to transfer records in the following circumstances:
1. if doing so would violate the federal Health Insurance Portability
and Accountability Act (HIPAA) or related regulations, which set
limits and rules regarding the disclosure of protected health
information;
2. in response to a direct request from another provider, unless the
provider can validate that he or she has a health provider
relationship with the patient; or 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 46 5/26/23
3. in response to a third-party request.
EFFECTIVE DATE: January 1, 2024
Background — Related Bill
sSB 958 (File 120), reported favorably by the Public Health
Committee, sets deadlines for licensed health care institutions to
transfer patient medical records to another institution upon receiving a
patient-approved request, requiring the transfer to occur (1)
immediately, for urgent requests, or (2) within two business days, for
non-urgent requests.
§ 45 — PRACTITIONER SHORTAGE TASK FORCE
Creates a task force to study how to address the state’s shortage of radiologic technologists,
nuclear medicine technologists, and respiratory care practitioners
The bill creates a task force to study ways to address the state’s
shortage of radiologic technologists, nuclear medicine technologists,
and respiratory care practitioners and make a plan to address this
shortage.
EFFECTIVE DATE: Upon passage
Membership and Administration
Under the bill, the task force includes the Public Health Committee
chairpersons and ranking members or their designees, and six
appointed members as shown below.
Table: Task Force Appointed Members
Appointing Authority Appointee Qualifications
House speaker Representative of a statewide association of
radiologic technologists, with expertise in that
profession
Senate president pro
tempore
Representative of a statewide association of
nuclear medicine technologists, with expertise in
that profession
House majority leader Representative of a statewide association of
respiratory care practitioners, with expertise in that
profession
Senate majority leader Representative of an association of hospitals in the 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 47 5/26/23
state
House minority leader Representative of a radiologists’ society in the state
Senate minority leader Representative of a medical society in the state,
with expertise in pulmonary issues
Under the bill, any members may be legislators. Initial appointments
must be made within 30 days after the bill’s passage. Appointing
authorities fill any vacancy.
The House speaker and Senate president pro tempore select the task
force chairpersons from among its members. The chairpersons must
schedule the first meeting, to be held within 60 days after the bill’s
passage.
The Public Health Committee’s administrative staff serves in that
capacity for the task force.
Reporting Requirement
The bill requires the task force to report its findings and
recommendations to the Public Health Committee by January 1, 2024.
The task force terminates when it submits the report or on January 1,
2024, whichever is later.
§§ 46 & 47 — BACKGROUND CHECKS FOR PHYSI CIAN AND
PSYCHOLOGIST LICENSU RE APPLICANTS
Requires psychologist licensure applicants, and physician applicants who wish to
participate in interstate compacts, to submit to a state and national fingerprint-based
criminal history records check by DESPP
The bill requires applicants for licensure as a (1) psychologist, or (2)
physician who intends to apply for a license in another state within one
year after applying for licensure, to submit to a state and national
fingerprint-based criminal history records check by DESPP. It requires
the DESPP commissioner to report the results of the physicians’ records
checks to the DPH commissioner (it does not require him to do this for
psychologists).
In doing this, the bill allows physicians and psychologists to
participate in the Interstate Medical Licensure Compact and the 2023SB-00009-R01-BA.DOCX
Researcher: JO Page 48 5/26/23
Psychology Interjurisdictional Compact, respectively, which
Connecticut joined under PA 22-81 (see Background). These compacts
require providers to complete an FBI fingerprint background check as a
condition of participation.
EFFECTIVE DATE: July 1, 2023
Background — Interstate Compacts
The Interstate Medical Licensure Compact provides an expedited
licensure process for physicians seeking to practice in multiple states.
The Psychology Interjurisdictional Compact provides a process
authorizing psychologists to practice by telehealth (unlimited) and
temporary in-person, face-to-face services (30 days per year per state)
across state boundaries, without having to be licensed in each of the
states.
COMMITTEE ACTION
Public Health Committee
Joint Favorable Substitute
Yea 27 Nay 10 (03/27/2023)
Appropriations Committee
Joint Favorable
Yea 41 Nay 12 (05/08/2023)