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Connecticut Senate Bill SB00007

Connecticut 2025 Regular Session

Connecticut Senate Bill SB00007 Compare Versions

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5-General Assembly Substitute Bill No. 7
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6+General Assembly Committee Bill No. 7
67 January Session, 2025
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810
11+Referred to Committee on PUBLIC HEALTH
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13+
14+Introduced by:
15+(PH)
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1219 AN ACT CONCERNING PROTECTIONS FOR ACCESS TO HEALTH
1320 CARE AND THE EQUITABLE DELIVERY OF HEALTH CARE
1421 SERVICES IN THE STATE.
1522 Be it enacted by the Senate and House of Representatives in General
1623 Assembly convened:
1724
1825 Section 1. Section 19a-38 of the general statutes is repealed and the 1
19-following is substituted in lieu thereof (Effective from passage): 2
26+following is substituted in lieu thereof (Effective October 1, 2025): 2
2027 A water company, as defined in section 25-32a, shall add a measured 3
2128 amount of fluoride to the water supply of any water system that it owns 4
2229 and operates and that serves twenty thousand or more persons so as to 5
2330 maintain an average monthly fluoride content that is not more or less 6
2431 than [0.15 of a milligram per liter different than the United States 7
2532 Department of Health and Human Services' most recent 8
2633 recommendation for optimal fluoride levels in drinking water to 9
2734 prevent tooth decay] 0.7 of a milligram of fluoride per liter of water 10
2835 provided such average monthly fluoride content shall not deviate 11
2936 greater or less than 0.15 of a milligram per liter. 12
3037 Sec. 2. (NEW) (Effective from passage) (a) The Commissioner of Public 13
3138 Health may establish an advisory committee to advise the commissioner 14
3239 on matters relating to recommendations by the Centers for Disease 15
33-Control and Prevention and the federal Food and Drug Administration 16
34-using evidence-based data from peer-reviewed literature and studies. 17 Substitute Bill No. 7
40+Committee Bill No. 7
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45+Control and Prevention and the federal Food and Drug Administration 16
46+using evidence-based data from peer-reviewed literature and studies. 17
3947 (b) The advisory committee may include, but need not be limited to, 18
4048 the following members: 19
4149 (1) The dean of a school of public health at an independent institution 20
4250 of higher education in the state; 21
4351 (2) The dean of a school of public health at a public institution of 22
4452 higher education in the state; 23
4553 (3) A physician specializing in primary care who (A) has not less than 24
4654 ten years of clinical practice experience, and (B) is a professor at a 25
4755 medical school in the state; 26
4856 (4) An infectious disease specialist who (A) has not less than ten years 27
4957 of clinical practice experience, and (B) is a professor at an institution of 28
5058 higher education in the state; 29
5159 (5) A pediatrician who (A) has not less than ten years of clinical 30
5260 practice experience and expertise in children's health and vaccinations, 31
5361 and (B) is a professor at an institution of higher education in the state; 32
5462 and 33
5563 (6) Any other individuals determined to be a beneficial member of 34
5664 the advisory committee by the Commissioner of Public Health. 35
5765 (c) The advisory committee shall serve in a nonbinding advisory 36
5866 capacity, providing guidance solely at the discretion of the 37
5967 Commissioner of Public Health. 38
60-Sec. 3. (NEW) (Effective July 1, 2025) (a) As used in this section: 39
61-(1) "Emergency medical condition" has the same meaning as 40
62-provided in section 4 of this act; 41
63-(2) "Emergency medical services" has the same meaning as provided 42
64-in section 4 of this act; 43
65-(3) "Gender-affirming health care services" has the same meaning as 44
66-provided in section 52-571n of the general statutes; 45 Substitute Bill No. 7
68+Sec. 3. Section 19a-508c of the general statutes is repealed and the 39
69+following is substituted in lieu thereof (Effective July 1, 2025): 40
70+(a) As used in this section: 41
71+(1) "Affiliated provider" means a provider that is: (A) Employed by a 42
72+Committee Bill No. 7
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71-(4) "Health care entity" means an entity that supervises, controls, 46
72-grants privileges to, directs the practice of or, directly or indirectly, 47
73-restricts the practice of a health care provider; 48
74-(5) "Health care provider" means a person who (A) provides health 49
75-care services, (B) is licensed, certified or registered pursuant to title 20 50
76-of the general statutes, and (C) is employed by or acting on behalf of a 51
77-health care entity; 52
78-(6) "Medically accurate and appropriate information and counseling" 53
79-means information and counseling that is (A) supported by the weight 54
80-of current scientific evidence, (B) derived from research using accepted 55
81-scientific methods, (C) consistent with generally recognized scientific 56
82-theory, (D) published in peer-reviewed journals, as appropriate, and (E) 57
83-recognized as accurate, complete, objective and in accordance with the 58
84-accepted standard of care by professional organizations and agencies 59
85-with expertise in the relevant field; 60
86-(7) "Medical hazard" has the same meaning as provided in section 4 61
87-of this act; and 62
88-(8) "Reproductive health care services" has the same meaning as 63
89-provided in section 52-571n of the general statutes. 64
90-(b) (1) No health care entity shall limit the ability of a health care 65
91-provider who is acting in good faith, within the health care provider's 66
92-scope of practice, education, training and experience, including the 67
93-health care provider's specialty area of practice and board certification, 68
94-and within the accepted standard of care, from providing the following 69
95-with regard to reproductive health care services and gender-affirming 70
96-health care services: 71
97-(A) Comprehensive, medically accurate and appropriate information 72
98-and counseling that (i) conforms to the accepted standard of care 73
99-provided to an individual patient, and (ii) concerns such patient's health 74
100-status, including, but not limited to, diagnosis, prognosis, 75
101-recommended treatment, treatment alternatives and potential risks to 76 Substitute Bill No. 7
77+hospital or health system, (B) under a professional services agreement 43
78+with a hospital or health system that permits such hospital or health 44
79+system to bill on behalf of such provider, or (C) a clinical faculty member 45
80+of a medical school, as defined in section 33-182aa, that is affiliated with 46
81+a hospital or health system in a manner that permits such hospital or 47
82+health system to bill on behalf of such clinical faculty member; 48
83+(2) "Campus" means: (A) The physical area immediately adjacent to a 49
84+hospital's main buildings and other areas and structures that are not 50
85+strictly contiguous to the main buildings but are located within two 51
86+hundred fifty yards of the main buildings, or (B) any other area that has 52
87+been determined on an individual case basis by the Centers for Medicare 53
88+and Medicaid Services to be part of a hospital's campus; 54
89+(3) "Facility fee" means any fee charged or billed by a hospital or 55
90+health system for outpatient services provided in a hospital-based 56
91+facility that is: (A) Intended to compensate the hospital or health system 57
92+for the operational expenses of the hospital or health system, and (B) 58
93+separate and distinct from a professional fee; 59
94+(4) "Health care provider" means an individual, entity, corporation, 60
95+person or organization, whether for-profit or nonprofit, that furnishes, 61
96+bills or is paid for health care service delivery in the normal course of 62
97+business, including, but not limited to, a health system, a hospital, a 63
98+hospital-based facility, a freestanding emergency department and an 64
99+urgent care center; 65
100+(5) "Health system" means: (A) A parent corporation of one or more 66
101+hospitals and any entity affiliated with such parent corporation through 67
102+ownership, governance, membership or other means, or (B) a hospital 68
103+and any entity affiliated with such hospital through ownership, 69
104+governance, membership or other means; 70
105+(6) "Hospital" has the same meaning as provided in section 19a-490; 71
106+(7) "Hospital-based facility" means a facility that is owned or 72
107+Committee Bill No. 7
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106-the patient's health or life; or 77
107-(B) Comprehensive, medically accurate and appropriate information 78
108-and counseling about available and relevant services and resources in 79
109-the community and methods to access such services and resources to 80
110-obtain health care of the patient's choosing. 81
111-(2) Nothing in subdivision (1) of this subsection shall be construed to 82
112-prohibit a health care entity that employs a health care provider from 83
113-performing relevant peer review of the health care provider or requiring 84
114-such health care provider to: 85
115-(A) Comply with preferred provider network or utilization review 86
116-requirements of any program or entity authorized by state or federal 87
117-law to provide insurance coverage for health care services to an enrollee; 88
118-and 89
119-(B) Meet established health care quality and patient safety guidelines 90
120-or rules. 91
121-(3) No health care entity shall discharge or discipline a health care 92
122-provider solely for providing information or counseling as described in 93
123-subdivision (1) of this subsection. 94
124-(c) (1) If a health care provider is acting in good faith, within the scope 95
125-of the health care provider's practice, education, training and experience 96
126-and within the accepted standard of care, a hospital with an emergency 97
127-department shall not prohibit the health care provider from providing 98
128-any emergency medical services, including reproductive health care 99
129-services, (A) if the failure to provide such services would violate the 100
130-accepted standard of care, or (B) if the patient is suffering from an 101
131-emergency medical condition. 102
132-(2) Nothing in subdivision (1) of this subsection shall be construed to 103
133-prohibit a health care entity from limiting a health care provider's 104
134-practice for purposes of: 105
135-(A) Complying with preferred provider network or utilization review 106 Substitute Bill No. 7
112+operated, in whole or in part, by a hospital or health system where 73
113+hospital or professional medical services are provided; 74
114+(8) "Medicaid" means the program operated by the Department of 75
115+Social Services pursuant to section 17b-260 and authorized by Title XIX 76
116+of the Social Security Act, as amended from time to time; 77
117+(9) "Observation" means services furnished by a hospital on the 78
118+hospital's campus, regardless of length of stay, including use of a bed 79
119+and periodic monitoring by the hospital's nursing or other staff to 80
120+evaluate an outpatient's condition or determine the need for admission 81
121+to the hospital as an inpatient; 82
122+(10) "Payer mix" means the proportion of different sources of 83
123+payment received by a hospital or health system, including, but not 84
124+limited to, Medicare, Medicaid, other government-provided insurance, 85
125+private insurance and self-pay patients; 86
126+(11) "Professional fee" means any fee charged or billed by a provider 87
127+for professional medical services provided in a hospital-based facility; 88
128+(12) "Provider" means an individual, entity, corporation or health 89
129+care provider, whether for profit or nonprofit, whose primary purpose 90
130+is to provide professional medical services; and 91
131+(13) "Tagline" means a short statement written in a non-English 92
132+language that indicates the availability of language assistance services 93
133+free of charge. 94
134+(b) If a hospital or health system charges a facility fee utilizing a 95
135+current procedural terminology evaluation and management (CPT 96
136+E/M) code, [or] assessment and management (CPT A/M) code , 97
137+injection and infusion (CPT) code or drug administration (CPT) code for 98
138+outpatient services provided at a hospital-based facility where a 99
139+professional fee is also expected to be charged, the hospital or health 100
140+system shall provide the patient with a written notice that includes the 101
141+following information: 102
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140-requirements of any program or entity authorized by state or federal 107
141-law to provide insurance coverage for health care services to an enrollee; 108
142-or 109
143-(B) Ensuring quality of care and patient safety, including, but not 110
144-limited to, when quality of care or patient safety issues are identified 111
145-pursuant to peer review. 112
146-(3) A health care entity shall not discharge or discipline a health care 113
147-provider for providing any emergency medical services, including, but 114
148-not limited to, reproductive health care services, (A) if the failure to 115
149-provide such services would violate the accepted standard of care, or 116
150-(B) if the patient is suffering from an emergency medical condition. 117
151-(4) A health care entity shall not discharge or discipline a health care 118
152-provider acting within the scope of such provider's practice, education, 119
153-training and experience and within the accepted standard of care who 120
154-refuses to transfer a patient when the health care provider determines, 121
155-within reasonable medical probability, that the transfer or delay caused 122
156-by the transfer will create a medical hazard to the patient. 123
157-Sec. 4. (NEW) (Effective July 1, 2025) As used in this section and 124
158-sections 5 to 12, inclusive, of this act: 125
159-(1) "Emergency medical services" means (A) medical screening, 126
160-examination and evaluation by a physician or any other licensed health 127
161-care provider acting independently or, as required by applicable law, 128
162-under the supervision of a physician, to determine if an emergency 129
163-medical condition or active labor exists and, if so, the care, treatment 130
164-and surgery that is (i) necessary to relieve or eliminate the emergency 131
165-medical condition, and (ii) within the scope of the facility's license where 132
166-the physician or provider is practicing, provided such care, treatment or 133
167-surgery is within the scope of practice of such physician or provider, 134
168-and (B) if it is determined that the emergency medical condition that 135
169-exists is a pregnancy complication, all reproductive health care services 136
170-related to the pregnancy complication, including, but not limited to, 137
171-miscarriage management and the treatment of an ectopic pregnancy, 138 Substitute Bill No. 7
147+(1) That the hospital-based facility is part of a hospital or health 103
148+system and that the hospital or health system charges a facility fee that 104
149+is in addition to and separate from the professional fee charged by the 105
150+provider; 106
151+(2) (A) The amount of the patient's potential financial liability, 107
152+including any facility fee likely to be charged, and, where professional 108
153+medical services are provided by an affiliated provider, any professional 109
154+fee likely to be charged, or, if the exact type and extent of the 110
155+professional medical services needed are not known or the terms of a 111
156+patient's health insurance coverage are not known with reasonable 112
157+certainty, an estimate of the patient's financial liability based on typical 113
158+or average charges for visits to the hospital-based facility, including the 114
159+facility fee, (B) a statement that the patient's actual financial liability will 115
160+depend on the professional medical services actually provided to the 116
161+patient, (C) an explanation that the patient may incur financial liability 117
162+that is greater than the patient would incur if the professional medical 118
163+services were not provided by a hospital-based facility, and (D) a 119
164+telephone number the patient may call for additional information 120
165+regarding such patient's potential financial liability, including an 121
166+estimate of the facility fee likely to be charged based on the scheduled 122
167+professional medical services; and 123
168+(3) That a patient covered by a health insurance policy should contact 124
169+the health insurer for additional information regarding the hospital's or 125
170+health system's charges and fees, including the patient's potential 126
171+financial liability, if any, for such charges and fees. 127
172+(c) If a hospital or health system charges a facility fee without 128
173+utilizing a current procedural terminology evaluation and management 129
174+(CPT E/M) code, assessment and management (CPT A/M) code, 130
175+injection and infusion (CPT) code or drug administration (CPT) code for 131
176+outpatient services provided at a hospital-based facility, located outside 132
177+the hospital campus, the hospital or health system shall provide the 133
178+patient with a written notice that includes the following information: 134
179+Committee Bill No. 7
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176-that are (i) necessary to relieve or eliminate the emergency medical 139
177-condition, and (ii) within the scope of the facility's license where the 140
178-physician or health care provider is providing such services, provided 141
179-such services are within the scope of practice of such physician or 142
180-provider. 143
181-(2) "Emergency medical condition" means a medical condition 144
182-manifesting itself by acute or severe symptoms, including, but not 145
183-limited to, severe pain, where the absence of immediate medical 146
184-attention could reasonably be expected to result in any of the following: 147
185-(A) Placement of the patient's life or health in serious jeopardy; 148
186-(B) Serious impairment to bodily functions; or 149
187-(C) Serious dysfunction of any bodily organ or part. 150
188-(3) "Active labor" means a labor at a time at which either of the 151
189-following is true: 152
190-(A) There is inadequate time to safely transfer the patient to another 153
191-hospital prior to delivery; or 154
192-(B) A transfer may pose a threat to the health and safety of the patient 155
193-or the fetus. 156
194-(4) "Hospital" has the same meaning as provided in section 19a-490 157
195-of the general statutes. 158
196-(5) "Medical hazard" means a material deterioration in, or jeopardy 159
197-to, a patient's medical condition or expected chances for recovery. 160
198-(6) "Qualified personnel" means a physician or other licensed health 161
199-care provider acting within the scope of such person's licensure who has 162
200-the necessary licensure, training, education and experience to provide 163
201-the emergency medical services necessary to stabilize a patient. 164
202-(7) "Consultation" means the rendering of an opinion or advice, 165
203-prescribing treatment or the rendering of a decision regarding 166 Substitute Bill No. 7
184+(1) That the hospital-based facility is part of a hospital or health 135
185+system and that the hospital or health system charges a facility fee that 136
186+may be in addition to and separate from the professional fee charged by 137
187+a provider; 138
188+(2) (A) A statement that the patient's actual financial liability will 139
189+depend on the professional medical services actually provided to the 140
190+patient, (B) an explanation that the patient may incur financial liability 141
191+that is greater than the patient would incur if the hospital-based facility 142
192+was not hospital-based, and (C) a telephone number the patient may call 143
193+for additional information regarding such patient's potential financial 144
194+liability, including an estimate of the facility fee likely to be charged 145
195+based on the scheduled professional medical services; and 146
196+(3) That a patient covered by a health insurance policy should contact 147
197+the health insurer for additional information regarding the hospital's or 148
198+health system's charges and fees, including the patient's potential 149
199+financial liability, if any, for such charges and fees. 150
200+(d) Each initial billing statement that includes a facility fee shall: (1) 151
201+Clearly identify the fee as a facility fee that is billed in addition to, or 152
202+separately from, any professional fee billed by the provider; (2) provide 153
203+the corresponding Medicare facility fee reimbursement rate for the same 154
204+service as a comparison or, if there is no corresponding Medicare facility 155
205+fee for such service, (A) the approximate amount Medicare would have 156
206+paid the hospital for the facility fee on the billing statement, or (B) the 157
207+percentage of the hospital's charges that Medicare would have paid the 158
208+hospital for the facility fee; (3) include a statement that the facility fee is 159
209+intended to cover the hospital's or health system's operational expenses; 160
210+(4) inform the patient that the patient's financial liability may have been 161
211+less if the services had been provided at a facility not owned or operated 162
212+by the hospital or health system; and (5) include written notice of the 163
213+patient's right to request a reduction in the facility fee or any other 164
214+portion of the bill and a telephone number that the patient may use to 165
215+request such a reduction without regard to whether such patient 166
216+Committee Bill No. 7
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208-hospitalization or transfer by telephone or other means of 167
209-communication, when determined to be medically necessary, jointly by 168
210-the (A) treating physician or other qualified personnel acting within the 169
211-scope of such personnel's licensure either independently or, when 170
212-required by law, under the supervision of a physician, and (B) 171
213-consulting physician, including, but not limited to, a review of the 172
214-patient's medical record and examination and treatment of the patient 173
215-in person, by telephone or through telehealth by a consulting physician 174
216-or other qualified personnel acting within the scope of such personnel's 175
217-licensure either independently or, when required by law, under the 176
218-supervision of a consulting physician, which physician or qualified 177
219-personnel is qualified to give an opinion or render the necessary 178
220-treatment to stabilize the patient. 179
221-(8) "Stabilized" means the patient's medical condition is such that, 180
222-within reasonable medical probability in the opinion of the treating 181
223-physician or any other qualified personnel acting within the scope of 182
224-such personnel's licensure either independently or, when required by 183
225-law, under the supervision of a treating physician, no medical hazard is 184
226-likely to result from, or occur during, the transfer or discharge of the 185
227-patient as provided in section 6 or 7 of this act or any other relevant 186
228-provision of the general statutes. 187
229-Sec. 5. (NEW) (Effective July 1, 2025) (a) Each hospital licensed 188
230-pursuant to chapter 368v of the general statutes that maintains and 189
231-operates (1) an emergency department to provide emergency medical 190
232-services to the public, or (2) a freestanding emergency department, as 191
233-defined in section 19a-493d of the general statutes, shall provide 192
234-emergency medical services to any person requesting such services, or 193
235-for whom such services are requested by an individual with authority 194
236-to act on behalf of the person, who has a medical condition that places 195
237-the person in danger of loss of life or serious injury or illness when the 196
238-hospital has appropriate facilities and qualified personnel available to 197
239-provide such services. 198
240-(b) No hospital or hospital employee and no physician or other 199 Substitute Bill No. 7
221+qualifies for, or is likely to be granted, any reduction. Not later than 167
222+October 15, 2022, and annually thereafter, each hospital, health system 168
223+and hospital-based facility shall submit to the Health Systems Planning 169
224+Unit of the Office of Health Strategy a sample of a billing statement 170
225+issued by such hospital, health system or hospital-based facility that 171
226+complies with the provisions of this subsection and which represents 172
227+the format of billing statements received by patients. Such billing 173
228+statement shall not contain patient identifying information. 174
229+(e) The written notice described in subsections (b) to (d), inclusive, 175
230+and (h) to (j), inclusive, of this section shall be in plain language and in 176
231+a form that may be reasonably understood by a patient who does not 177
232+possess special knowledge regarding hospital or health system facility 178
233+fee charges. On and after October 1, 2022, such notices shall include tag 179
234+lines in at least the top fifteen languages spoken in the state indicating 180
235+that the notice is available in each of those top fifteen languages. The 181
236+fifteen languages shall be either the languages in the list published by 182
237+the Department of Health and Human Services in connection with 183
238+section 1557 of the Patient Protection and Affordable Care Act, P.L. 111-184
239+148, or, as determined by the hospital or health system, the top fifteen 185
240+languages in the geographic area of the hospital-based facility. 186
241+(f) (1) For nonemergency care, if a patient's appointment is scheduled 187
242+to occur ten or more days after the appointment is made, such written 188
243+notice shall be sent to the patient by first class mail, encrypted electronic 189
244+mail or a secure patient Internet portal not less than three days after the 190
245+appointment is made. If an appointment is scheduled to occur less than 191
246+ten days after the appointment is made or if the patient arrives without 192
247+an appointment, such notice shall be hand-delivered to the patient when 193
248+the patient arrives at the hospital-based facility. 194
249+(2) For emergency care, such written notice shall be provided to the 195
250+patient as soon as practicable after the patient is stabilized in accordance 196
251+with the federal Emergency Medical Treatment and Active Labor Act, 197
252+42 USC 1395dd, as amended from time to time, or is determined not to 198
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245-licensed health care provider affiliated with a hospital shall be liable 200
246-under this section in any action arising out of a refusal of the hospital, 201
247-hospital employee, physician or other licensed health care provider to 202
248-render emergency medical services to a person if the refusal is based on 203
249-the hospital's, hospital employee's, physician's or provider's 204
250-determination, while exercising reasonable care, that (1) such person is 205
251-not experiencing an emergency medical condition, or (2) the hospital 206
252-does not have the appropriate facilities or qualified personnel available 207
253-to render such services to such person. 208
254-(c) A hospital shall render emergency medical services to a person 209
255-without first questioning such person or any other individual regarding 210
256-such person's ability to pay for such services. A hospital may follow 211
257-reasonable registration processes for persons for whom an examination 212
258-is required under this section, including, but not limited to, inquiring as 213
259-to whether the person has health insurance and, if so, details regarding 214
260-such health insurance, provided such inquiry does not delay an 215
261-evaluation of such person or the provision of emergency medical 216
262-services to such person. Such reasonable registration processes may not 217
263-unduly discourage persons from remaining at the hospital for further 218
264-evaluation. 219
265-Sec. 6. (NEW) (Effective July 1, 2025) (a) A hospital shall not transfer 220
266-any person needing emergency medical services to another hospital for 221
267-any nonmedical reason, including, but not limited to, the person's 222
268-inability to pay for any emergency medical services, unless each of the 223
269-following conditions are met: 224
270-(1) A physician has examined and evaluated the person prior to 225
271-transfer, including, if necessary, by engaging in a consultation. A 226
272-request for consultation shall be made by the treating physician or by 227
273-other qualified personnel acting within the scope of such personnel's 228
274-licensure either independently or, when required by law, under the 229
275-supervision of a treating physician, provided the request by such 230
276-qualified personnel is made with the contemporaneous approval of the 231
277-treating physician. 232 Substitute Bill No. 7
258+have an emergency medical condition and before the patient leaves the 199
259+hospital-based facility. If the patient is unconscious, under great duress 200
260+or for any other reason unable to read the notice and understand and 201
261+act on his or her rights, the notice shall be provided to the patient's 202
262+representative as soon as practicable. 203
263+(g) Subsections (b) to (f), inclusive, and (l) of this section shall not 204
264+apply if a patient is insured by Medicare or Medicaid or is receiving 205
265+services under a workers' compensation plan established to provide 206
266+medical services pursuant to chapter 568. 207
267+(h) A hospital-based facility shall prominently display written notice 208
268+in locations that are readily accessible to and visible by patients, 209
269+including patient waiting or appointment check-in areas, stating: (1) 210
270+That the hospital-based facility is part of a hospital or health system, (2) 211
271+the name of the hospital or health system, and (3) that if the hospital-212
272+based facility charges a facility fee, the patient may incur a financial 213
273+liability greater than the patient would incur if the hospital-based 214
274+facility was not hospital-based. On and after October 1, 2022, such 215
275+notices shall include tag lines in at least the top fifteen languages spoken 216
276+in the state indicating that the notice is available in each of those top 217
277+fifteen languages. The fifteen languages shall be either the languages in 218
278+the list published by the Department of Health and Human Services in 219
279+connection with section 1557 of the Patient Protection and Affordable 220
280+Care Act, P.L. 111-148, or, as determined by the hospital or health 221
281+system, the top fifteen languages in the geographic area of the hospital-222
282+based facility. Not later than October 1, 2022, and annually thereafter, 223
283+each hospital-based facility shall submit a copy of the written notice 224
284+required by this subsection to the Health Systems Planning Unit of the 225
285+Office of Health Strategy. 226
286+(i) A hospital-based facility shall clearly hold itself out to the public 227
287+and payers as being hospital-based, including, at a minimum, by stating 228
288+the name of the hospital or health system in its signage, marketing 229
289+materials, Internet web sites and stationery. 230
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282-(2) The person has been provided with emergency medical services, 233
283-including, but not limited to, an abortion, if an abortion was medically 234
284-necessary to stabilize the patient, and it can be determined by the 235
285-hospital, within reasonable medical probability, that such person's 236
286-emergency medical condition has been stabilized and the transfer or 237
287-delay caused by the transfer will not create a medical hazard to such 238
288-person. 239
289-(3) A physician at the transferring hospital has notified the receiving 240
290-hospital and obtained consent to the transfer of the person from a 241
291-physician at the receiving hospital and confirmation by the receiving 242
292-hospital that the person meets the receiving hospital's admissions 243
293-criteria relating to appropriate bed, personnel and equipment necessary 244
294-to treat the person. 245
295-(4) The transferring hospital has provided for appropriate personnel 246
296-and equipment that a reasonable and prudent physician in the same or 247
297-similar locality exercising ordinary care would use to affect the transfer. 248
298-(5) All of the person's pertinent medical records and copies of all of 249
299-the appropriate diagnostic test results that are reasonably available have 250
300-been compiled for transfer with the person. Transfer of medical records 251
301-may be accomplished by a transfer of physical records or by confirming 252
302-that the receiving hospital has access to the patient's electronic medical 253
303-records from the transferring hospital. 254
304-(6) The records transferred with the person shall include a transfer 255
305-summary signed by the transferring physician that contains relevant 256
306-transfer information available to the transferring hospital at the time of 257
307-transfer. The form of the transfer summary shall, at a minimum, contain 258
308-(A) the person's name, address, sex, race, age, insurance status, 259
309-presenting symptoms and medical condition, (B) the name and business 260
310-address of the transferring physician or emergency department 261
311-personnel authorizing the transfer, (C) the declaration of the signor that 262
312-the signor is assured, within reasonable medical probability, that the 263
313-transfer creates no medical hazard to the patient, (D) the time and date 264 Substitute Bill No. 7
295+(j) A hospital-based facility shall, when scheduling services for which 231
296+a facility fee may be charged, inform the patient (1) that the hospital-232
297+based facility is part of a hospital or health system, (2) of the name of the 233
298+hospital or health system, (3) that the hospital or health system may 234
299+charge a facility fee in addition to and separate from the professional fee 235
300+charged by the provider, and (4) of the telephone number the patient 236
301+may call for additional information regarding such patient's potential 237
302+financial liability. 238
303+(k) (1) If any transaction described in subsection (c) of section 19a-239
304+486i results in the establishment of a hospital-based facility at which 240
305+facility fees may be billed, the hospital or health system, that is the 241
306+purchaser in such transaction shall, not later than thirty days after such 242
307+transaction, provide written notice, by first class mail, of the transaction 243
308+to each patient served within the three years preceding the date of the 244
309+transaction by the health care facility that has been purchased as part of 245
310+such transaction. 246
311+(2) Such notice shall include the following information: 247
312+(A) A statement that the health care facility is now a hospital-based 248
313+facility and is part of a hospital or health system, the health care facility's 249
314+full legal and business name and the date of such facility's acquisition 250
315+by a hospital or health system; 251
316+(B) The name, business address and phone number of the hospital or 252
317+health system that is the purchaser of the health care facility; 253
318+(C) A statement that the hospital-based facility bills, or is likely to bill, 254
319+patients a facility fee that may be in addition to, and separate from, any 255
320+professional fee billed by a health care provider at the hospital-based 256
321+facility; 257
322+(D) (i) A statement that the patient's actual financial liability will 258
323+depend on the professional medical services actually provided to the 259
324+patient, and (ii) an explanation that the patient may incur financial 260
325+Committee Bill No. 7
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318-of the transfer, (E) the reason for the transfer, (F) the time and date the 265
319-person was first presented at the transferring hospital, and (G) the name 266
320-of the physician at the receiving hospital consenting to the transfer and 267
321-the time and date of the consent. Neither the transferring physician nor 268
322-the transferring hospital shall be required to duplicate, in the transfer 269
323-summary, information contained in medical records transferred with 270
324-the person. 271
325-(7) The hospital shall ask the patient if the patient has a preferred 272
326-contact person to be notified about the transfer and, prior to the transfer, 273
327-the hospital shall make a reasonable attempt to contact such person and 274
328-alert them about the proposed transfer. If the patient is not able to 275
329-respond, the hospital shall make a reasonable effort to ascertain the 276
330-identity of the preferred contact person or the next of kin and alert such 277
331-person about the transfer. The hospital shall document in the patient's 278
332-medical record any attempt to contact a preferred contact person or next 279
333-of kin. 280
334-(b) Nothing in this section shall be construed to prohibit the transfer 281
335-or discharge of a patient when the patient or the patient's authorized 282
336-representative, including a parent or guardian of the patient, requests a 283
337-transfer or discharge and gives informed consent to the transfer or 284
338-discharge against medical advice. 285
339-(c) The Department of Public Health shall adopt regulations, in 286
340-accordance with the provisions of chapter 54 of the general statutes, to 287
341-implement the provisions of this section. 288
342-Sec. 7. (NEW) (Effective July 1, 2025) (a) A receiving hospital shall 289
343-accept the transfer of a person from a transferring hospital to the extent 290
344-required pursuant to section 6 of this act or any contract obligation the 291
345-receiving hospital has to care for the person. 292
346-(b) The receiving hospital shall provide personnel and equipment 293
347-reasonably required by the applicable standard of practice and the 294
348-regulations adopted pursuant to section 6 of this act to care for the 295
349-transferred patient. 296 Substitute Bill No. 7
330+liability that is greater than the patient would incur if the hospital-based 261
331+facility were not a hospital-based facility; 262
332+(E) The estimated amount or range of amounts the hospital-based 263
333+facility may bill for a facility fee or an example of the average facility fee 264
334+billed at such hospital-based facility for the most common services 265
335+provided at such hospital-based facility; and 266
336+(F) A statement that, prior to seeking services at such hospital-based 267
337+facility, a patient covered by a health insurance policy should contact 268
338+the patient's health insurer for additional information regarding the 269
339+hospital-based facility fees, including the patient's potential financial 270
340+liability, if any, for such fees. 271
341+(3) A copy of the written notice provided to patients in accordance 272
342+with this subsection shall be filed with the Health Systems Planning 273
343+Unit of the Office of Health Strategy, established under section 19a-612. 274
344+Said unit shall post a link to such notice on its Internet web site. 275
345+(4) A hospital, health system or hospital-based facility shall not collect 276
346+a facility fee for services provided at a hospital-based facility that is 277
347+subject to the provisions of this subsection from the date of the 278
348+transaction until at least thirty days after the written notice required 279
349+pursuant to this subsection is mailed to the patient or a copy of such 280
350+notice is filed with the Health Systems Planning Unit of the Office of 281
351+Health Strategy, whichever is later. A violation of this subsection shall 282
352+be considered an unfair trade practice pursuant to section 42-110b. 283
353+(5) Not later than July 1, 2023, and annually thereafter, each hospital-284
354+based facility that was the subject of a transaction, as described in 285
355+subsection (c) of section 19a-486i, during the preceding calendar year 286
356+shall report to the Health Systems Planning Unit of the Office of Health 287
357+Strategy the number of patients served by such hospital-based facility 288
358+in the preceding three years. 289
359+(l) (1) Notwithstanding the provisions of this section, no hospital, 290
360+Committee Bill No. 7
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354-(c) Any hospital that has suffered a financial loss as a direct result of 297
355-a hospital's improper transfer of a person or refusal to accept a person 298
356-for whom the hospital has a legal obligation to provide care may, in a 299
357-civil action against the participating hospital, obtain damages for such 300
358-financial loss and such equitable relief as is appropriate. 301
359-(d) Nothing in this section shall be construed to require a hospital to 302
360-receive a person from a transferring hospital and make arrangements 303
361-for the care of a person for whom the hospital does not have a legal 304
362-obligation to provide care. 305
363-Sec. 8. (NEW) (Effective July 1, 2025) (a) The Commissioner of Public 306
364-Health shall require as a condition of licensure of a hospital, pursuant 307
365-to section 19a-491 of the general statutes, that each hospital adopt, in 308
366-collaboration with the medical staff of the hospital, policies and transfer 309
367-protocols consistent with sections 3 to 12, inclusive, of this act and the 310
368-regulations adopted pursuant to section 6 of this act. 311
369-(b) The commissioner shall require as a condition of licensure of a 312
370-hospital, pursuant to section 19a-491 of the general statutes, that each 313
371-hospital communicate, both orally and in writing, to each person who 314
372-presents to the hospital's emergency department, or such person's 315
373-authorized representative, if any such representative is present and the 316
374-person is unable to understand verbal or written communication, of the 317
375-reasons for the transfer or refusal to provide emergency medical services 318
376-and of the person's right to receive such services to stabilize an 319
377-emergency medical condition prior to transfer to another hospital or 320
378-health care facility or discharge without regard to ability to pay. 321
379-Nothing in this subsection shall be construed to require notification of 322
380-the reasons for the transfer in advance of the transfer when (1) a person 323
381-is unaccompanied, (2) the hospital has made a reasonable effort to locate 324
382-an authorized representative of the person, and (3) due to the person's 325
383-physical or mental condition, notification is not possible. Each hospital 326
384-shall prominently post a sign in its emergency department informing 327
385-the public of their rights under sections 3 to 12, inclusive, of this act. 328
386-Both the written communication and sign required under this 329 Substitute Bill No. 7
365+health system or hospital-based facility shall collect a facility fee for (A) 291
366+outpatient health care services that use a current procedural 292
367+terminology evaluation and management (CPT E/M) code , [or] 293
368+assessment and management (CPT A/M) code, injection and infusion 294
369+(CPT) code or drug administration (CPT) code and are provided at a 295
370+hospital-based facility located off-site from a hospital campus, or (B) 296
371+outpatient health care services provided at a hospital-based facility 297
372+located off-site from a hospital campus received by a patient who is 298
373+uninsured of more than the Medicare rate. 299
374+(2) Notwithstanding the provisions of this section, on and after July 300
375+1, 2024, no hospital or health system shall collect a facility fee for 301
376+outpatient health care services that use a current procedural 302
377+terminology evaluation and management (CPT E/M) code or 303
378+assessment and management (CPT A/M) code and are provided on the 304
379+hospital campus. The provisions of this subdivision shall not apply to 305
380+(A) an emergency department located on a hospital campus, or (B) 306
381+observation stays on a hospital campus and (CPT E/M) and (CPT A/M) 307
382+codes when billed for the following services: (i) Wound care, (ii) 308
383+orthopedics, (iii) anticoagulation, (iv) oncology, (v) obstetrics, and (vi) 309
384+solid organ transplant. 310
385+(3) Notwithstanding the provisions of subdivisions (1) and (2) of this 311
386+subsection, in circumstances when an insurance contract that is in effect 312
387+on July 1, 2016, provides reimbursement for facility fees prohibited 313
388+under the provisions of subdivision (1) of this subsection, and in 314
389+circumstances when an insurance contract that is in effect on July 1, 315
390+2024, provides reimbursement for facility fees prohibited under the 316
391+provisions of subdivision (2) of this subsection, a hospital or health 317
392+system may continue to collect reimbursement from the health insurer 318
393+for such facility fees until the applicable date of expiration, renewal or 319
394+amendment of such contract, whichever such date is the earliest. 320
395+(4) The provisions of this subsection shall not apply to a freestanding 321
396+emergency department. As used in this subdivision, "freestanding 322
397+Committee Bill No. 7
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391-subsection shall include the contact information for the Department of 330
392-Public Health and identify the department as the state agency to contact 331
393-if a person wishes to complain about the hospital's conduct. 332
394-(c) Not later than thirty days after the adoption of regulations 333
395-pursuant to section 6 of this act, each hospital shall submit its policies 334
396-and protocols adopted pursuant to subsection (a) of this section to the 335
397-Department of Public Health. Each hospital shall submit any revisions 336
398-to such policies or protocols to the department not later than thirty days 337
399-prior to the effective date of such revisions. 338
400-Sec. 9. (NEW) (Effective July 1, 2025) (a) Each hospital shall maintain 339
401-records of each transfer of a person made or received, including the 340
402-transfer summary described in subdivision (6) of subsection (a) of 341
403-section 6 of this act, for a period of not less than three years following 342
404-the date of the transfer. 343
405-(b) Each hospital making or receiving transfers of persons shall file 344
406-with the Department of Public Health annual reports, in a form and 345
407-manner prescribed by the Commissioner of Public Health, that shall 346
408-describe the aggregate number of transfers made and received, the 347
409-insurance status of each person transferred and the reasons for such 348
410-transfers. 349
411-(c) Each receiving hospital, physician and licensed emergency room 350
412-health care personnel at the receiving hospital, and each licensed 351
413-emergency medical services personnel, as defined in section 19a-175 of 352
414-the general statutes, effectuating the transfer of a person who knows of 353
415-an apparent violation of any provision of sections 4 to 11, inclusive, of 354
416-this act or the regulations adopted pursuant to section 6 of this act, shall, 355
417-and each transferring hospital and each physician and other provider 356
418-involved in the transfer at such hospital may, report such violation to 357
419-the Department of Public Health, in a form and manner prescribed by 358
420-the Commissioner of Public Health, not later than fourteen days after 359
421-the occurrence of such violation. When two or more persons required to 360
422-report a violation have joint knowledge of an apparent violation, a 361 Substitute Bill No. 7
402+emergency department" means a freestanding facility that (A) is 323
403+structurally separate and distinct from a hospital, (B) provides 324
404+emergency care, (C) is a department of a hospital licensed under chapter 325
405+368v, and (D) has been issued a certificate of need to operate as a 326
406+freestanding emergency department pursuant to chapter 368z. 327
407+(5) (A) On and after July 1, 2024, if the Commissioner of Health 328
408+Strategy receives information and has a reasonable belief, after 329
409+evaluating such information, that any hospital, health system or 330
410+hospital-based facility charged facility fees, other than through isolated 331
411+clerical or electronic billing errors, in violation of any provision of this 332
412+section, or rule or regulation adopted thereunder, such hospital, health 333
413+system or hospital-based facility shall be subject to a civil penalty of up 334
414+to one thousand dollars. The commissioner may issue a notice of 335
415+violation and civil penalty by first class mail or personal service. Such 336
416+notice shall include: (i) A reference to the section of the general statutes, 337
417+rule or section of the regulations of Connecticut state agencies believed 338
418+or alleged to have been violated; (ii) a short and plain language 339
419+statement of the matters asserted or charged; (iii) a description of the 340
420+activity to cease; (iv) a statement of the amount of the civil penalty or 341
421+penalties that may be imposed; (v) a statement concerning the right to a 342
422+hearing; and (vi) a statement that such hospital, health system or 343
423+hospital-based facility may, not later than ten business days after receipt 344
424+of such notice, make a request for a hearing on the matters asserted. 345
425+(B) The hospital, health system or hospital-based facility to whom 346
426+such notice is provided pursuant to subparagraph (A) of this 347
427+subdivision may, not later than ten business days after receipt of such 348
428+notice, make written application to the Office of Health Strategy to 349
429+request a hearing to demonstrate that such violation did not occur. The 350
430+failure to make a timely request for a hearing shall result in the issuance 351
431+of a cease and desist order or civil penalty. All hearings held under this 352
432+subsection shall be conducted in accordance with the provisions of 353
433+chapter 54. 354
434+Committee Bill No. 7
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427-single report may be made by a member of the hospital personnel 362
428-selected by mutual agreement in accordance with hospital protocols. 363
429-Any person required to report a violation who disagrees with a 364
430-proposed joint report shall report individually. 365
431-(d) No hospital, state agency or person shall retaliate against, 366
432-penalize, institute a civil action against or recover monetary relief from, 367
433-or otherwise cause any injury to, any physician, other hospital personnel 368
434-or emergency medical services personnel for reporting in good faith an 369
435-apparent violation of any provision of sections 4 to 11, inclusive, of this 370
436-act or the regulations adopted pursuant to section 6 of this act to the 371
437-Department of Public Health, the hospital, a member of the hospital's 372
438-medical staff or any other interested party or government agency. 373
439-Sec. 10. (NEW) (Effective July 1, 2025) (a) Except as otherwise provided 374
440-in sections 4 to 11, inclusive, of this act, the Commissioner of Public 375
441-Health shall investigate each alleged violation of said sections and the 376
442-regulations adopted pursuant to section 6 of this act unless the 377
443-commissioner concludes that the allegation does not include facts 378
444-requiring further investigation or is otherwise unmeritorious. 379
445-(b) The Commissioner of Public Health may take any action 380
446-authorized by sections 19a-494 and 19a-494a of the general statutes 381
447-against a hospital or authorized by section 19a-17 of the general statutes 382
448-against a licensed health care provider for a violation of any provision 383
449-of sections 4 to 11, inclusive, of this act. 384
450-Sec. 11. (NEW) (Effective July 1, 2025) (a) A hospital shall not base the 385
451-provision of emergency medical services to a person, in whole or in part, 386
452-upon, or discriminate against a person based upon, the person's 387
453-ethnicity, citizenship, age, preexisting medical condition, insurance 388
454-status, economic status, ability to pay for medical services, sex, race, 389
455-color, religion, disability, genetic information, marital status, sexual 390
456-orientation, gender identity or expression, primary language or 391
457-immigration status, except to the extent that a circumstance such as age, 392
458-sex, pregnancy, medical condition related to childbirth, preexisting 393 Substitute Bill No. 7
439+(C) Following any hearing before the Office of Health Strategy 355
440+pursuant to this subdivision, if said office finds, by a preponderance of 356
441+the evidence, that such hospital, health system or hospital-based facility 357
442+violated or is violating any provision of this subsection, any rule or 358
443+regulation adopted thereunder or any order issued by said office, said 359
444+office shall issue a final cease and desist order in addition to any civil 360
445+penalty said office imposes. 361
446+(6) A violation of this subsection shall be considered an unfair trade 362
447+practice pursuant to section 42-110b. 363
448+(m) (1) Each hospital and health system shall report not later than 364
449+October 1, 2023, and thereafter not later than July 1, 2024, and annually 365
450+thereafter, to the Commissioner of Health Strategy, on a form prescribed 366
451+by the commissioner, concerning facility fees charged or billed during 367
452+the preceding calendar year. Such report shall include, but need not be 368
453+limited to, (A) the name and address of each facility owned or operated 369
454+by the hospital or health system that provides services for which a 370
455+facility fee is charged or billed, and an indication as to whether each 371
456+facility is located on or outside of the hospital or health system campus, 372
457+(B) the number of patient visits at each such facility for which a facility 373
458+fee was charged or billed, (C) the number, total amount and range of 374
459+allowable facility fees paid at each such facility disaggregated by payer 375
460+mix, (D) for each facility, the total amount of facility fees charged and 376
461+the total amount of revenue received by the hospital or health system 377
462+derived from facility fees, (E) the total amount of facility fees charged 378
463+and the total amount of revenue received by the hospital or health 379
464+system from all facilities derived from facility fees, (F) a description of 380
465+the ten procedures or services that generated the greatest amount of 381
466+facility fee gross revenue, disaggregated by current procedural 382
467+terminology (CPT) category [(CPT)] code for each such procedure or 383
468+service and, for each such procedure or service, patient volume and the 384
469+total amount of gross and net revenue received by the hospital or health 385
470+system derived from facility fees, disaggregated by on-campus and off-386
471+campus, and (G) the top ten procedures or services for which facility 387
472+Committee Bill No. 7
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463-medical condition or physical or mental disability is medically 394
464-significant to the provision of appropriate medical care to the patient. 395
465-Each hospital shall adopt a policy to implement the provisions of this 396
466-section. 397
467-(b) Unless otherwise permitted by contract, each hospital shall 398
468-prohibit each physician who serves on an on-call basis in the hospital's 399
469-emergency department from refusing to respond to a call on the basis of 400
470-the person's ethnicity, citizenship, age, preexisting medical condition, 401
471-insurance status, economic status, ability to pay for medical services, 402
472-sex, race, color, religion, disability, current medical condition, genetic 403
473-information, marital status, sexual orientation, primary language or 404
474-immigration status, except to the extent that a circumstance such as age, 405
475-sex, preexisting medical condition or physical or mental disability is 406
476-medically significant to the provision of appropriate medical care to the 407
477-patient. If a contract that was in existence on or before July 1, 2025, 408
478-between a physician and hospital for the provision of emergency 409
479-department coverage prevents a hospital from imposing the prohibition 410
480-required under this subsection, the contract shall be revised to include 411
481-such prohibition as soon as it is legally permissible to make such a 412
482-revision. Nothing in this section shall be construed to require any 413
483-physician to serve on an on-call basis for a hospital. 414
484-Sec. 12. (NEW) (Effective July 1, 2025) (a) Any individual harmed by a 415
485-violation of any provision of sections 3 to 11, inclusive, of this act may 416
486-bring, not later than one hundred eighty days after the occurrence of 417
487-such violation, a civil action against a hospital or other health care entity 418
488-for such violation. 419
489-(b) Any hospital or other health care entity found to have violated 420
490-any provision of sections 3 to 11, inclusive, of this act shall be liable for 421
491-compensatory damages, with costs and such reasonable attorney's fees 422
492-as may be allowed by the court. In the case of a health care provider who 423
493-has been subjected to retaliation or other disciplinary action in violation 424
494-of any provision of sections 3 to 11, inclusive, of this act, the hospital or 425
495-other health care entity shall also be liable for the full amount of gross 426 Substitute Bill No. 7
477+fees are charged based on patient volume and the gross and net revenue 388
478+received by the hospital or health system for each such procedure or 389
479+service, disaggregated by on-campus and off-campus. For purposes of 390
480+this subsection, "facility" means a hospital-based facility that is located 391
481+on a hospital campus or outside a hospital campus. 392
482+(2) The commissioner shall publish the information reported 393
483+pursuant to subdivision (1) of this subsection, or post a link to such 394
484+information, on the Internet web site of the Office of Health Strategy. 395
485+Sec. 4. (NEW) (Effective July 1, 2025) (a) As used in this section: 396
486+(1) "Emergency medical condition" has the same meaning as 397
487+provided in section 5 of this act; 398
488+(2) "Emergency medical services" has the same meaning as provided 399
489+in section 5 of this act; 400
490+(3) "Gender-affirming health care services" has the same meaning as 401
491+provided in section 52-571n of the general statutes; 402
492+(4) "Health care entity" means an entity that supervises, controls, 403
493+grants privileges to, directs the practice of or, directly or indirectly, 404
494+restricts the practice of a health care provider; 405
495+(5) "Health care provider" means a person who (A) provides health 406
496+care services, (B) is licensed, certified or registered pursuant to title 20 407
497+of the general statutes, and (C) is employed or acting on behalf of a 408
498+health care entity; 409
499+(6) "Medically accurate and appropriate information and counseling" 410
500+means information and counseling that is (A) supported by the weight 411
501+of current scientific evidence, (B) derived from research using accepted 412
502+scientific methods, (C) consistent with generally recognized scientific 413
503+theory, (D) published in peer-reviewed journals, as appropriate, and (E) 414
504+recognized as accurate, complete, objective and in accordance with the 415
505+accepted standard of care by professional organizations and agencies 416
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500-loss of wages in addition to any compensatory damages for which the 427
501-hospital or health care entity is liable under this subsection. 428
502-(c) The court may also provide injunctive relief to prevent further 429
503-violations of any provision of sections 3 to 11, inclusive, of this act. 430
504-(d) If the court determines that an action for damages was brought 431
505-under this section without substantial justification, the court may award 432
506-costs and reasonable attorney's fees to the hospital or other health care 433
507-entity. 434
508-(e) Nothing in this section shall preclude any other causes of action 435
509-authorized by law or prevent the state or any professional licensing 436
510-board from taking any action authorized by the general statutes against 437
511-the hospital, health care entity or an individual health care provider. 438
512-Sec. 13. (NEW) (Effective July 1, 2025) (a) As used in this section: 439
513-(1) "Collateral costs" means any out-of-pocket costs, other than the 440
514-cost of the procedure itself, necessary to receive reproductive health care 441
515-services or gender-affirming health care services in the state, including, 442
516-but not limited to, costs for travel, lodging and meals; 443
517-(2) "Gender-affirming health care services" has the same meaning as 444
518-provided in section 52-571n of the general statutes; 445
519-(3) "Health care provider" means any person licensed under the 446
520-provisions of federal or state law to provide health care services; 447
521-(4) "Nonprofit organization" means an organization that is exempt 448
522-from taxation pursuant to Section 501(c)(3) of the Internal Revenue Code 449
523-of 1986, or any subsequent corresponding internal revenue code of the 450
524-United States, as amended from time to time; 451
525-(5) "Patient-identifiable data" means any information that identifies, 452
526-or may reasonably be used as a basis to identify, an individual patient; 453
527-(6) "Qualified person" means a person who is a resident of a state that 454 Substitute Bill No. 7
511+with expertise in the relevant field; 417
512+(7) "Medical hazard" has the same meaning as provided in section 5 418
513+of this act; and 419
514+(8) "Reproductive health care services" has the same meaning as 420
515+provided in section 52-571n of the general statutes. 421
516+(b) (1) No health care entity shall limit the ability of a health care 422
517+provider who is acting in good faith, within the health care provider's 423
518+scope of practice, education, training and experience, including the 424
519+health care provider's specialty area of practice and board certification, 425
520+and within the accepted standard of care, from providing the following 426
521+with regard to reproductive health care services and gender-affirming 427
522+health care services: 428
523+(A) Comprehensive, medically accurate and appropriate information 429
524+and counseling that (i) conforms to the accepted standard of care 430
525+provided to an individual patient, and (ii) concerns such patient's health 431
526+status, including, but not limited to, diagnosis, prognosis, 432
527+recommended treatment, treatment alternatives and potential risks to 433
528+the patient's health or life; or 434
529+(B) Comprehensive, medically accurate and appropriate information 435
530+and counseling about available and relevant services and resources in 436
531+the community and methods to access such services and resources to 437
532+obtain health care of the patient's choosing. 438
533+(2) Nothing in subdivision (1) of this subsection shall be construed to 439
534+prohibit a health care entity that employs a health care provider from 440
535+performing relevant peer review of the health care provider or requiring 441
536+such health care provider to: 442
537+(A) Comply with preferred provider network or utilization review 443
538+requirements of any program or entity authorized by state or federal 444
539+law to provide insurance coverage for health care services to an enrollee; 445
540+and 446
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532-has enacted laws that limit such person's access to reproductive health 455
533-care services or gender-affirming health care services; and 456
534-(7) "Reproductive health care services" means all medical, surgical, 457
535-counseling or referral services relating to the human reproductive 458
536-system, including, but not limited to, services relating to fertility, 459
537-pregnancy, contraception and abortion. 460
538-(b) There is established an account to be known as the "safe harbor 461
539-account", which shall be a separate, nonlapsing account of the State 462
540-Treasurer. The account shall contain any funds received from any 463
541-private contributions, gifts, grants, donations, bequests or devises to the 464
542-account. Moneys in the account shall be expended by the board of 465
543-trustees, established pursuant to subsection (c) of this section, for the 466
544-purposes of providing grants to (1) health care providers who provide 467
545-reproductive health care services or gender-affirming health care 468
546-services, (2) nonprofit organizations whose mission includes providing 469
547-funding for reproductive health care services or the collateral costs 470
548-incurred by qualified persons to receive such services in the state, or (3) 471
549-nonprofit organizations that serve LGBTQ+ youth or families in the 472
550-state for the purpose of reimbursing or paying for collateral costs 473
551-incurred by qualified persons to receive reproductive health care 474
552-services or gender-affirming health care services. 475
553-(c) The safe harbor account shall be administered by a board of 476
554-trustees consisting of the following members: 477
555-(1) The Treasurer, or the Treasurer's designee, who shall serve as 478
556-chairperson of the board of trustees; 479
557-(2) The Commissioner of Mental Health and Addiction Services, or 480
558-the commissioner's designee; 481
559-(3) The Commissioner of Social Services, or the commissioner's 482
560-designee; 483
561-(4) The Commissioner of Public Health, or the commissioner's 484 Substitute Bill No. 7
546+(B) Meet established health care quality and patient safety guidelines 447
547+or rules. 448
548+(3) No health care entity shall discharge or discipline a health care 449
549+provider solely for providing information or counseling as described in 450
550+subdivision (1) of this subsection. 451
551+(c) (1) If a health care provider is acting in good faith, within the scope 452
552+of the health care provider's practice, education, training and experience 453
553+and within the accepted standard of care, a hospital with an emergency 454
554+department shall not prohibit the health care provider from providing 455
555+any emergency medical services, including reproductive health care 456
556+services, (A) if the failure to provide such services would violate the 457
557+accepted standard of care, or (B) if the patient is suffering from an 458
558+emergency medical condition. 459
559+(2) Nothing in subdivision (1) of this subsection shall be construed to 460
560+prohibit a health care entity from limiting a health care provider's 461
561+practice for purposes of: 462
562+(A) Complying with preferred provider network or utilization review 463
563+requirements of any program or entity authorized by state or federal 464
564+law to provide insurance coverage for health care services to an enrollee; 465
565+or 466
566+(B) Ensuring quality of care and patient safety, including, but not 467
567+limited to, when quality of care or patient safety issues are identified 468
568+pursuant to peer review. 469
569+(3) A health care entity shall not discharge or discipline a health care 470
570+provider for providing any emergency medical services, including, but 471
571+not limited to, reproductive health care services, (A) if the failure to 472
572+provide such services would violate the accepted standard of care, or 473
573+(B) if the patient is suffering from an emergency medical condition. 474
574+(4) A health care entity shall not discharge or discipline a health care 475
575+provider acting within the scope of such provider's practice, education, 476
576+Committee Bill No. 7
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566-designee; and 485
567-(5) Five members appointed by the Treasurer, (A) one of whom shall 486
568-be a provider of reproductive health care services in the state, (B) one of 487
569-whom shall have experience working with members of the LGBTQ+ 488
570-community, and (C) one of whom shall have experience working with 489
571-providers of reproductive health care services. When making such 490
572-appointments, the Treasurer shall use the Treasurer's best efforts to 491
573-ensure that the board of trustees reflects the racial, gender and 492
574-geographic diversity of the state. 493
575-(d) Not later than September 1, 2025, the board of trustees shall adopt 494
576-policies and procedures concerning the awarding of grants pursuant to 495
577-the provisions of this section. Such policies and procedures shall 496
578-include, but need not be limited to, (1) grant application procedures, (2) 497
579-eligibility criteria for applicants, (3) eligibility criteria for collateral costs, 498
580-(4) consideration of need, including, but not limited to, financial need, 499
581-of the applicant, and (5) procedures to coordinate with any national 500
582-network created to perform similar functions to those of the safe harbor 501
583-account, including, but not limited to, procedures for the acceptance of 502
584-funding transferred to the safe harbor account for a particular use. Such 503
585-policies and procedures shall not require the collection or retention of 504
586-patient-identifiable data in order to receive a grant. Such policies and 505
587-procedures may be updated as deemed necessary by the board of 506
588-trustees. In the event that the board of trustees determines that the 507
589-policies and procedures adopted pursuant to the provisions of this 508
590-subsection are inadequate with respect to (A) determining the eligibility 509
591-of a certain health care provider or nonprofit organization for a grant, 510
592-or (B) whether a certain health care service received by a qualified 511
593-person or collateral cost incurred by a qualified person is eligible to be 512
594-reimbursed or paid by a health care provider or nonprofit organization 513
595-using grant moneys received pursuant to this section, the board of 514
596-trustees may make a fact-based determination as to such eligibility. 515
597-Sec. 14. (NEW) (Effective from passage) It is hereby declared that opioid 516
598-use disorder constitutes a public health crisis in this state and will 517 Substitute Bill No. 7
581+training and experience and within the accepted standard of care who 477
582+refuses to transfer a patient when the health care provider determines, 478
583+within reasonable medical probability, that the transfer or delay caused 479
584+by the transfer will create a medical hazard to the patient. 480
585+Sec. 5. (NEW) (Effective July 1, 2025) As used in this section and 481
586+sections 6 to 13, inclusive, of this act: 482
587+(1) "Emergency medical services" means (A) medical screening, 483
588+examination and evaluation by a physician or any other licensed health 484
589+care provider acting independently or, as required by applicable law, 485
590+under the supervision of a physician, to determine if an emergency 486
591+medical condition or active labor exists and, if so, the care, treatment 487
592+and surgery that is (i) necessary to relieve or eliminate the emergency 488
593+medical condition, and (ii) within the scope of the facility's license where 489
594+the physician or provider is practicing, provided such care, treatment or 490
595+surgery is within the scope of practice of such physician or provider, (B) 491
596+if it is determined that the emergency medical condition that exists is a 492
597+pregnancy complication, all reproductive health care services related to 493
598+the pregnancy complication, including, but not limited to, miscarriage 494
599+management and the treatment of an ectopic pregnancy, that are (i) 495
600+necessary to relieve or eliminate the emergency medical condition, and 496
601+(ii) within the scope of the facility's license where the physician or health 497
602+care provider is providing such services, provided such services are 498
603+within the scope of practice of such physician or provider. 499
604+(2) "Emergency medical condition" means a medical condition 500
605+manifesting itself by acute or severe symptoms, including, but not 501
606+limited to, severe pain, where the absence of immediate medical 502
607+attention could reasonably be expected to result in any of the following: 503
608+(A) Placement of the patient's life or health in serious jeopardy; 504
609+(B) Serious impairment to bodily functions; or 505
610+(C) Serious dysfunction of any bodily organ or part. 506
611+Committee Bill No. 7
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603-continue to constitute a public health crisis until each goal reported by 518
604-the Connecticut Alcohol and Drug Policy Council pursuant to 519
605-subsection (f) of section 17a-667a of the general statutes, as amended by 520
606-this act, is attained. 521
607-Sec. 15. Section 17a-667a of the general statutes is amended by adding 522
608-subsection (f) as follows (Effective from passage): 523
609-(NEW) (f) The Connecticut Alcohol and Drug Policy Council shall 524
610-convene a working group to establish one or more goals for the state to 525
611-achieve in its efforts to combat the prevalence of opioid use disorder in 526
612-the state. Not later than January 1, 2026, the council shall report, in 527
613-accordance with the provisions of section 11-4a, to the joint standing 528
614-committee of the General Assembly having cognizance of matters 529
615-relating to public health regarding each goal established by the working 530
616-group. 531
617-Sec. 16. (Effective from passage) (a) As used in this section: 532
618-(1) "Priority school district" has the same meaning as described in 533
619-section 10-266p of the general statutes; and 534
620-(2) "Geofence" means any technology that uses global positioning 535
621-coordinates, cell tower connectivity, cellular data, radio frequency 536
622-identification, wireless fidelity technology data or any other form of 537
623-location detection, or any combination of such coordinates, connectivity, 538
624-data, identification or other form of location detection, to establish a 539
625-virtual boundary. 540
626-(b) Not later than January 1, 2026, the Department of Education, in 541
627-consultation with the Department of Children and Families, shall 542
628-establish a mental and behavioral health awareness and treatment pilot 543
629-program in priority school districts. The program shall enable not less 544
630-than one hundred thousand students in such districts to utilize an 545
631-electronic mental and behavioral health awareness and treatment tool 546
632-through an Internet web site, online service or mobile application, which 547
633-tool shall be selected by the Commissioner of Education and provide 548 Substitute Bill No. 7
616+(3) "Active labor" means a labor at a time at which either of the 507
617+following is true: 508
618+(A) There is inadequate time to safely transfer the patient to another 509
619+hospital prior to delivery; or 510
620+(B) A transfer may pose a threat to the health and safety of the patient 511
621+or the fetus. 512
622+(4) "Hospital" has the same meaning as provided in section 19a-490 513
623+of the general statutes. 514
624+(5) "Medical hazard" means a material deterioration in, or jeopardy 515
625+to, a patient's medical condition or expected chances for recovery. 516
626+(6) "Qualified personnel" means a physician or other licensed health 517
627+care provider acting within the scope of such person's licensure who has 518
628+the necessary licensure, training, education and experience to provide 519
629+the emergency medical services necessary to stabilize a patient. 520
630+(7) "Consultation" means the rendering of an opinion or advice, 521
631+prescribing treatment or the rendering of a decision regarding 522
632+hospitalization or transfer by telephone or other means of 523
633+communication, when determined to be medically necessary, jointly by 524
634+the (A) treating physician or other qualified personnel acting within the 525
635+scope of such personnel's licensure either independently or, when 526
636+required by law, under the supervision of a physician, and (B) 527
637+consulting physician, including, but not limited to, a review of the 528
638+patient's medical record and examination and treatment of the patient 529
639+in person, by telephone or through telehealth by a consulting physician 530
640+or other qualified personnel acting within the scope of such personnel's 531
641+licensure either independently or, when required by law, under the 532
642+supervision of a consulting physician, which physician or qualified 533
643+personnel is qualified to give an opinion or render the necessary 534
644+treatment to stabilize the patient. 535
645+(8) "Stabilized" means the patient's medical condition is such that, 536
646+Committee Bill No. 7
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638-each of the following: 549
639-(1) Mental and behavioral health education resources to promote 550
640-awareness and understanding of mental and behavioral health issues; 551
641-(2) Peer-to-peer support services, including, but not limited to, a 552
642-moderated online peer chat room, where comments submitted by 553
643-students for posting in the chat room are prescreened and filtered 554
644-through by a moderator prior to posting, to encourage social connection 555
645-and mutual support among students; and 556
646-(3) Private online sessions with mental or behavioral health care 557
647-providers licensed in the state who (A) have demonstrated experience 558
648-delivering mental or behavioral health care services to school districts 559
649-serving both rural and urban student populations, and (B) shall be 560
650-selected or approved by the Commissioner of Education, provided such 561
651-sessions comply with the provisions of section 19a-906 of the general 562
652-statutes concerning telehealth and the provisions of section 19a-14c of 563
653-the general statutes concerning the provision of outpatient mental 564
654-health treatment to minors. 565
655-(c) (1) During its first year of operation, the pilot program shall have 566
656-the following objectives: (A) To build partnerships between priority 567
657-school districts and community organizations providing mental and 568
658-behavioral health care services; and (B) to launch a digital marketing 569
659-campaign using tools, including, but not limited to, a geofence, to raise 570
660-awareness and engagement among students concerning mental and 571
661-behavioral health issues affecting students. 572
662-(2) Not later than January 1, 2026, the Commissioner of Education 573
663-shall report, in accordance with the provisions of section 11-4a of the 574
664-general statutes, regarding the program's success in achieving such 575
665-objectives to the joint standing committees of the General Assembly 576
666-having cognizance of matters relating to public health and education. 577
667-(d) (1) During its second year of operation, the pilot program shall 578
668-have the following objectives: (A) To refer students to mental and 579 Substitute Bill No. 7
651+within reasonable medical probability in the opinion of the treating 537
652+physician or any other qualified personnel acting within the scope of 538
653+such personnel's licensure either independently or, when required by 539
654+law, under the supervision of a treating physician, no medical hazard is 540
655+likely to result from, or occur during, the transfer or discharge of the 541
656+patient as provided in section 7 or 8 of this act or any other relevant 542
657+provision of the general statutes. 543
658+Sec. 6. (NEW) (Effective July 1, 2025) (a) Each hospital licensed 544
659+pursuant to chapter 368v of the general statutes that maintains and 545
660+operates (1) an emergency department to provide emergency medical 546
661+services to the public, or (2) a freestanding emergency department, as 547
662+defined in section 19a-493d of the general statutes, shall provide 548
663+emergency medical services to any person requesting such services, or 549
664+for whom such services are requested by an individual with authority 550
665+to act on behalf of the person, who has a medical condition that places 551
666+the person in danger of loss of life or serious injury or illness when the 552
667+hospital has appropriate facilities and qualified personnel available to 553
668+provide such services. 554
669+(b) No hospital or hospital employee and no physician or other 555
670+licensed health care provider affiliated with a hospital shall be liable 556
671+under this section in any action arising out of a refusal of the hospital, 557
672+hospital employee, physician or other licensed health care provider to 558
673+render emergency medical services to a person if the refusal is based on 559
674+the hospital's, hospital employee's, physician's or provider's 560
675+determination, while exercising reasonable care, that (1) such person is 561
676+not experiencing an emergency medical condition, or (2) the hospital 562
677+does not have the appropriate facilities or qualified personnel available 563
678+to render such services to such person. 564
679+(c) A hospital shall render emergency medical services to a person 565
680+without first questioning such person or any other individual regarding 566
681+such person's ability to pay for such services. A hospital may follow 567
682+reasonable registration processes for persons for whom an examination 568
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673-behavioral health care providers, as needed; and (B) to enhance 580
674-students' engagement with mental and behavioral health tools, 581
675-including, but not limited to, coping strategies and clinician support. 582
676-(2) Not later than January 1, 2027, the Commissioner of Education 583
677-shall report, in accordance with the provisions of section 11-4a of the 584
678-general statutes, regarding the program's success in achieving such 585
679-objectives to the joint standing committees of the General Assembly 586
680-having cognizance of matters relating to public health and education. 587
681-Sec. 17. (Effective from passage) The sum of three million six hundred 588
682-thousand dollars is appropriated to the Department of Education from 589
683-the General Fund, for the fiscal year ending June 30, 2026, for the 590
684-administration of the mental and behavioral health awareness and 591
685-treatment pilot program established pursuant to section 16 of this act. 592
686-Sec. 18. (NEW) (Effective from passage) There is established an account 593
687-to be known as the "public health urgent communication account", 594
688-which shall be a separate, nonlapsing account. The account shall contain 595
689-any moneys required by law to be deposited in the account. Moneys in 596
690-the account shall be expended by the Department of Public Health for 597
691-the purposes of providing timely, effective communication to members 598
692-of the general public, health care providers and other relevant 599
693-stakeholders during a public health emergency, as described in section 600
694-19a-131a of the general statutes. 601
695-Sec. 19. (Effective from passage) The sum of five million dollars is 602
696-appropriated to the Department of Public Health from the General 603
697-Fund, for the fiscal year ending June 30, 2026, for deposit into the "public 604
698-health urgent communication account" established pursuant to section 605
699-18 of this act. 606
700-Sec. 20. (NEW) (Effective from passage) There is established an account 607
701-to be known as the "emergency public health financial safeguard 608
702-account", which shall be a separate, nonlapsing account. The account 609
703-shall contain any moneys required by law to be deposited in the account. 610
704-Moneys in the account shall be expended by the Department of Public 611 Substitute Bill No. 7
688+is required under this section, including, but not limited to, inquiring as 569
689+to whether the person has health insurance and, if so, details regarding 570
690+such health insurance, provided such inquiry does not delay an 571
691+evaluation of such person or the provision of emergency medical 572
692+services to such person. Such reasonable registration processes may not 573
693+unduly discourage persons from remaining at the hospital for further 574
694+evaluation. 575
695+Sec. 7. (NEW) (Effective July 1, 2025) (a) A hospital shall not transfer 576
696+any person needing emergency medical services to another hospital for 577
697+any nonmedical reason, including, but not limited to, the person's 578
698+inability to pay for any emergency medical services, unless each of the 579
699+following conditions are met: 580
700+(1) A physician has examined and evaluated the person prior to 581
701+transfer, including, if necessary, by engaging in a consultation. A 582
702+request for consultation shall be made by the treating physician or by 583
703+other qualified personnel acting within the scope of such personnel's 584
704+licensure either independently or, when required by law, under the 585
705+supervision of a treating physician, provided the request by such 586
706+qualified personnel is made with the contemporaneous approval of the 587
707+treating physician. 588
708+(2) The person has been provided with emergency medical services, 589
709+including, but not limited to, an abortion, if an abortion was medically 590
710+necessary to stabilize the patient, and it can be determined by the 591
711+hospital, within reasonable medical probability, that such person's 592
712+emergency medical condition has been stabilized and the transfer or 593
713+delay caused by the transfer will not create a medical hazard to such 594
714+person. 595
715+(3) A physician at the transferring hospital has notified the receiving 596
716+hospital and obtained consent to the transfer of the person from a 597
717+physician at the receiving hospital and confirmation by the receiving 598
718+hospital that the person meets the receiving hospital's admissions 599
719+criteria relating to appropriate bed, personnel and equipment necessary 600
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709-Health for the purposes of addressing unexpected shortfalls in public 612
710-health funding and ensuring the Department of Public Health's ability 613
711-to respond to the health care needs of state residents and provide a 614
712-continuity of essential public health services. 615
713-Sec. 21. (Effective from passage) The sum of thirty million dollars is 616
714-appropriated to the Department of Public Health from the General 617
715-Fund, for the fiscal year ending June 30, 2026, for deposit into the 618
716-"emergency public health financial safeguard account" established 619
717-pursuant to section 20 of this act. 620
718-Sec. 22. (NEW) (Effective October 1, 2025) As used in this section and 621
719-sections 23 to 25, inclusive, of this act: 622
720-(1) "Commissioner" means the Commissioner of Public Health; 623
721-(2) "Department" means the Department of Public Health; 624
722-(3) "Health care administrator" means a person employed by a 625
723-hospital who is a: 626
724-(A) Nonclinical hospital manager with direct supervisory authority 627
725-over clinical health care providers who is responsible for one or more of 628
726-the following activities: 629
727-(i) Hiring, scheduling, evaluating and providing direct supervision 630
728-of clinical health care providers; 631
729-(ii) Monitoring hospital activities for compliance with state or federal 632
730-regulatory requirements; or 633
731-(iii) Developing fiscal reports for clinical units of the hospital or the 634
732-hospital as a whole; or 635
733-(B) Nonclinical hospital director, officer or executive who has direct 636
734-or indirect supervisory authority over only nonclinical hospital 637
735-managers described in subparagraph (A) of this subdivision, for one or 638
736-more of the following activities: 639 Substitute Bill No. 7
725+to treat the person. 601
726+(4) The transferring hospital has provided for appropriate personnel 602
727+and equipment that a reasonable and prudent physician in the same or 603
728+similar locality exercising ordinary care would use to affect the transfer. 604
729+(5) All of the person's pertinent medical records and copies of all of 605
730+the appropriate diagnostic test results that are reasonably available have 606
731+been compiled for transfer with the person. Transfer of medical records 607
732+may be accomplished by a transfer of physical records or by confirming 608
733+that the receiving hospital has access to the patient's electronic medical 609
734+records from the transferring hospital. 610
735+(6) The records transferred with the person shall include a transfer 611
736+summary signed by the transferring physician that contains relevant 612
737+transfer information available to the transferring hospital at the time of 613
738+transfer. The form of the transfer summary shall, at a minimum, contain 614
739+(A) the person's name, address, sex, race, age, insurance status, 615
740+presenting symptoms and medical condition, (B) the name and business 616
741+address of the transferring physician or emergency department 617
742+personnel authorizing the transfer, (C) the declaration of the signor that 618
743+the signor is assured, within reasonable medical probability, that the 619
744+transfer creates no medical hazard to the patient, (D) the time and date 620
745+of the transfer, (E) the reason for the transfer, (F) the time and date the 621
746+person was first presented at the transferring hospital, and (G) the name 622
747+of the physician at the receiving hospital consenting to the transfer and 623
748+the time and date of the consent. Neither the transferring physician nor 624
749+the transferring hospital shall be required to duplicate, in the transfer 625
750+summary, information contained in medical records transferred with 626
751+the person. 627
752+(7) The hospital shall ask the patient if the patient has a preferred 628
753+contact person to be notified about the transfer and, prior to the transfer, 629
754+the hospital shall make a reasonable attempt to contact such person and 630
755+alert them about the proposed transfer. If the patient is not able to 631
756+respond, the hospital shall make a reasonable effort to ascertain the 632
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741-(i) Hiring and supervising such nonclinical hospital managers; 640
742-(ii) Providing oversight of operations for the hospital or any of its 641
743-departments; 642
744-(iii) Developing policies and procedures establishing the standards of 643
745-patient care; 644
746-(iv) Providing oversight of budgetary and financial decisions related 645
747-to operations and the delivery of patient care for the hospital or any of 646
748-its departments; and 647
749-(v) Ensuring that hospital policies comply with state and federal 648
750-regulatory requirements; and 649
751-(4) "Hospital" means an institution licensed as a hospital pursuant to 650
752-chapter 368v of the general statutes. 651
753-Sec. 23. (NEW) (Effective October 1, 2025) (a) No person shall practice 652
754-as a health care administrator unless such person is licensed pursuant 653
755-to section 24 of this act. 654
756-(b) No person may use the title "health care administrator" or make 655
757-use of any title, words, letters or abbreviations indicating or implying 656
758-that such person is licensed to practice as a health care administrator 657
759-pursuant to section 24 of this act. 658
760-Sec. 24. (NEW) (Effective October 1, 2025) (a) Except as provided in 659
761-subsection (b) of this section, the commissioner shall grant a license to 660
762-practice as a health care administrator to an applicant who presents 661
763-evidence satisfactory to the commissioner that such applicant has: (1) A 662
764-baccalaureate or graduate degree in health care administration, public 663
765-health or a related field from a regionally accredited institution of higher 664
766-education, or from an institution of higher education outside of the 665
767-United States that is legally chartered to grant postsecondary degrees in 666
768-the country in which such institution is located; (2) passed an 667
769-examination prescribed by the department designed to test the 668
770-applicant's knowledge of health care laws, patient safety protocols and 669 Substitute Bill No. 7
762+identity of the preferred contact person or the next of kin and alert such 633
763+person about the transfer. The hospital shall document in the patient's 634
764+medical record any attempt to contact a preferred contact person or next 635
765+of kin. 636
766+(b) Nothing in this section shall be construed to prohibit the transfer 637
767+or discharge of a patient when the patient or the patient's authorized 638
768+representative, including a parent or guardian of the patient, requests a 639
769+transfer or discharge and gives informed consent to the transfer or 640
770+discharge against medical advice. 641
771+(c) The Department of Public Health shall adopt regulations, in 642
772+accordance with the provisions of chapter 54 of the general statutes, to 643
773+implement the provisions of this section. 644
774+Sec. 8. (NEW) (Effective July 1, 2025) (a) A receiving hospital shall 645
775+accept the transfer of a person from a transferring hospital to the extent 646
776+required pursuant to section 7 of this act or any contract obligation the 647
777+receiving hospital has to care for the person. 648
778+(b) The receiving hospital shall provide personnel and equipment 649
779+reasonably required by the applicable standard of practice and the 650
780+regulations adopted pursuant to section 7 of this act to care for the 651
781+transferred patient. 652
782+(c) Any hospital that has suffered a financial loss as a direct result of 653
783+a hospital's improper transfer of a person or refusal to accept a person 654
784+for whom the hospital has a legal obligation to provide care may, in a 655
785+civil action against the participating hospital, obtain damages for such 656
786+financial loss and such equitable relief as is appropriate. 657
787+(d) Nothing in this section shall be construed to require a hospital to 658
788+receive a person from a transferring hospital and make arrangements 659
789+for the care of a person for whom the hospital does not have a legal 660
790+obligation to provide care. 661
791+Sec. 9. (NEW) (Effective July 1, 2025) (a) The Commissioner of Public 662
792+Committee Bill No. 7
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775-health-related ethical guidelines; and (3) submitted a completed 670
776-application in a form and manner prescribed by the department. The fee 671
777-for an initial license under this section shall be two hundred dollars. 672
778-(b) The department may grant licensure without examination, subject 673
779-to payment of fees with respect to the initial application, to any 674
780-applicant who is currently licensed or certified as a health care 675
781-administrator in another state, territory or commonwealth of the United 676
782-States, provided such state, territory or commonwealth maintains 677
783-licensure or certification standards that, in the opinion of the 678
784-department, are equivalent to or higher than the standards of this state. 679
785-No license shall be issued under this section to any applicant against 680
786-whom professional disciplinary action is pending or who is the subject 681
787-of an unresolved complaint. 682
788-(c) A license issued to a health care administrator under this section 683
789-may be renewed annually in accordance with the provisions of section 684
790-19a-88 of the general statutes, as amended by this act. The fee for such 685
791-renewal shall be one hundred five dollars. Each licensed health care 686
792-administrator applying for license renewal shall furnish evidence 687
793-satisfactory to the commissioner of having participated in continuing 688
794-education programs prescribed by the department. The commissioner 689
795-shall adopt regulations, in accordance with chapter 54 of the general 690
796-statutes, to (1) define basic requirements for continuing education 691
797-programs, (2) delineate qualifying programs, (3) establish a system of 692
798-control and reporting, and (4) provide for waiver of the continuing 693
799-education requirement for good cause. 694
800-Sec. 25. (NEW) (Effective October 1, 2025) (a) The department shall 695
801-have jurisdiction to hear all charges of unacceptable conduct brought 696
802-against a person licensed as a health care administrator. The 697
803-commissioner shall provide written notice of such hearing to such 698
804-person not later than thirty days prior to such hearing. After holding 699
805-such hearing, the department may take any of the actions set forth in 700
806-section 19a-17 of the general statutes, if it finds that any grounds for 701
807-action by the department enumerated in subsection (b) of this section 702 Substitute Bill No. 7
797+Health shall require as a condition of licensure of a hospital, pursuant 663
798+to section 19a-491 of the general statutes, that each hospital adopt, in 664
799+collaboration with the medical staff of the hospital, policies and transfer 665
800+protocols consistent with sections 4 to 13, inclusive, of this act and the 666
801+regulations adopted pursuant to section 7 of this act. 667
802+(b) The commissioner shall require as a condition of licensure of a 668
803+hospital, pursuant to section 19a-491 of the general statutes, that each 669
804+hospital communicate, both orally and in writing, to each person who 670
805+presents to the hospital's emergency department, or such person's 671
806+authorized representative, if any such representative is present and the 672
807+person is unable to understand verbal or written communication, of the 673
808+reasons for the transfer or refusal to provide emergency medical services 674
809+and of the person's right to receive such services to stabilize an 675
810+emergency medical condition prior to transfer to another hospital or 676
811+health care facility or discharge without regard to ability to pay. 677
812+Nothing in this subsection shall be construed to require notification of 678
813+the reasons for the transfer in advance of the transfer when (1) a person 679
814+is unaccompanied, (2) the hospital has made a reasonable effort to locate 680
815+an authorized representative of the person, and (3) due to the person's 681
816+physical or mental condition, notification is not possible. Each hospital 682
817+shall prominently post a sign in its emergency department informing 683
818+the public of their rights under sections 4 to 13, inclusive, of this act. 684
819+Both the written communication and sign required under this 685
820+subsection shall include the contact information for the Department of 686
821+Public Health and identify the department as the state agency to contact 687
822+if a person wishes to complain about the hospital's conduct. 688
823+(c) Not later than thirty days after the adoption of regulations 689
824+pursuant to section 7 of this act, each hospital shall submit its policies 690
825+and protocols adopted pursuant to subsection (a) of this section to the 691
826+Department of Public Health. Each hospital shall submit any revisions 692
827+to such policies or protocols to the department not later than thirty days 693
828+prior to the effective date of such revisions. 694
829+Committee Bill No. 7
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812-exist. Any person aggrieved by the finding of the department may 703
813-appeal such finding in accordance with the provisions of section 4-183 704
814-of the general statutes, and such appeal shall have precedence over 705
815-nonprivileged cases in respect to order of trial. 706
816-(b) The department may take action under section 19a-17 of the 707
817-general statutes for any of the following reasons: (1) A fiscal or 708
818-operational decision that results in injury to a patient or creates an 709
819-unreasonable risk that a patient may be harmed; (2) a violation by a 710
820-licensed health care provider of a state or federal statute or 711
821-administrative rule regulating a profession when the health care 712
822-administrator was responsible for the oversight of the licensed health 713
823-care provider; (3) aiding or abetting a licensed health care provider to 714
824-practice the provider's health care profession after a patient complaint 715
825-or adverse event has been reported to the hospital employing the 716
826-licensed health care administrator, the department or the appropriate 717
827-disciplining authority, while the complaint or adverse event is being 718
828-investigated, and if harm, disability or death of a patient occurred after 719
829-the complaint or report of the adverse event; (4) failure to adequately 720
830-supervise licensed clinical staff and nonclinical staff to the extent that a 721
831-patient's health or safety is at risk; (5) any administrative, operational or 722
832-fiscal decision that impedes a clinical licensed health care provider from 723
833-adhering to standards of practice or leads to patient harm, disability or 724
834-death; or (6) a fiscal or operational decision resulting in the inability of 725
835-licensed clinical health care providers to practice with reasonable skill 726
836-and safety, regardless of the occurrence of patient harm, disability or 727
837-death. The commissioner may order a license holder to submit to a 728
838-reasonable physical or mental examination if such license holder's 729
839-physical or mental capacity to practice safely is being investigated. The 730
840-commissioner may petition the superior court for the judicial district of 731
841-Hartford to enforce such order or any action taken pursuant to section 732
842-19a-17 of the general statutes. 733
843-Sec. 26. Subdivision (1) of subsection (e) of section 19a-88 of the 734
844-general statutes is repealed and the following is substituted in lieu 735
845-thereof (Effective October 1, 2025): 736 Substitute Bill No. 7
834+Sec. 10. (NEW) (Effective July 1, 2025) (a) Each hospital shall maintain 695
835+records of each transfer of a person made or received, including the 696
836+transfer summary described in subdivision (6) of subsection (a) of 697
837+section 7 of this act, for a period of not less than three years following 698
838+the date of the transfer. 699
839+(b) Each hospital making or receiving transfers of persons shall file 700
840+with the Department of Public Health annual reports, in a form and 701
841+manner prescribed by the Commissioner of Public Health, that shall 702
842+describe the aggregate number of transfers made and received, the 703
843+insurance status of each person transferred and the reasons for such 704
844+transfers. 705
845+(c) Each receiving hospital, physician and licensed emergency room 706
846+health care personnel at the receiving hospital, and each licensed 707
847+emergency medical services personnel, as defined in section 19a-175 of 708
848+the general statutes, effectuating the transfer of a person who knows of 709
849+an apparent violation of any provision of sections 5 to 12, inclusive, of 710
850+this act or the regulations adopted pursuant to section 7 of this act, shall, 711
851+and each transferring hospital and each physician and other provider 712
852+involved in the transfer at such hospital may, report such violation to 713
853+the Department of Public Health, in a form and manner prescribed by 714
854+the Commissioner of Public Health, not later than fourteen days after 715
855+the occurrence of such violation. When two or more persons required to 716
856+report a violation have joint knowledge of an apparent violation, a 717
857+single report may be made by a member of the hospital personnel 718
858+selected by mutual agreement in accordance with hospital protocols. 719
859+Any person required to report a violation who disagrees with a 720
860+proposed joint report shall report individually. 721
861+(d) No hospital, state agency or person shall retaliate against, 722
862+penalize, institute a civil action against or recover monetary relief from, 723
863+or otherwise cause any injury to, any physician, other hospital personnel 724
864+or emergency medical services personnel for reporting in good faith an 725
865+apparent violation of any provision of sections 5 to 12, inclusive, of this 726
866+Committee Bill No. 7
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849870
850-(e) (1) Each person holding a license or certificate issued under 737
851-section 24 of this act, section 19a-514, 20-65k, 20-74s, 20-185k, 20-185l, 20-738
852-195cc or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to 381a, 739
853-inclusive, 383 to 383c, inclusive, 383g, 384, 384a, 384b, 385, 393a, 395, 399 740
854-or 400a and section 20-206n or 20-206o shall, annually, or, in the case of 741
855-a person holding a license as a marital and family therapist associate 742
856-under section 20-195c on or before twenty-four months after the date of 743
857-initial licensure, during the month of such person's birth, apply for 744
858-renewal of such license or certificate to the Department of Public Health, 745
859-giving such person's name in full, such person's residence and business 746
860-address and such other information as the department requests. 747
861-Sec. 27. (NEW) (Effective July 1, 2025) (a) As used in this section: 748
862-(1) "Advanced practice registered nurse" means an individual 749
863-licensed as an advanced practice registered nurse pursuant to chapter 750
864-378 of the general statutes; 751
865-(2) "Physician" means an individual licensed as a physician pursuant 752
866-to chapter 370 of the general statutes; 753
867-(3) "Physician assistant" means an individual licensed as a physician 754
868-assistant pursuant to chapter 370 of the general statutes; and 755
869-(4) "Sudden unexpected death in epilepsy" means the death of a 756
870-person with epilepsy that is not caused by injury, drowning or other 757
871-known causes unrelated to epilepsy. 758
872-(b) On and after October 1, 2025, each physician, advanced practice 759
873-registered nurse and physician assistant who regularly treats patients 760
874-with epilepsy shall provide each such patient with information 761
875-concerning the risk of sudden unexpected death in epilepsy and 762
876-methods to mitigate such risk. 763
871+act or the regulations adopted pursuant to section 7 of this act to the 727
872+Department of Public Health, the hospital, a member of the hospital's 728
873+medical staff or any other interested party or government agency. 729
874+Sec. 11. (NEW) (Effective July 1, 2025) (a) Except as otherwise provided 730
875+in sections 5 to 12, inclusive, of this act, the Commissioner of Public 731
876+Health shall investigate each alleged violation of said sections and the 732
877+regulations adopted pursuant to section 7 of this act unless the 733
878+commissioner concludes that the allegation does not include facts 734
879+requiring further investigation or is otherwise unmeritorious. 735
880+(b) The Commissioner of Public Health may take any action 736
881+authorized by sections 19a-494 and 19a-494a of the general statutes 737
882+against a hospital or authorized by section 19a-17 of the general statutes 738
883+against a licensed health care provider for a violation of any provision 739
884+of sections 5 to 12, inclusive, of this act. 740
885+Sec. 12. (NEW) (Effective July 1, 2025) (a) A hospital shall not base the 741
886+provision of emergency medical services to a person, in whole or in part, 742
887+upon, or discriminate against a person based upon, the person's 743
888+ethnicity, citizenship, age, preexisting medical condition, insurance 744
889+status, economic status, ability to pay for medical services, sex, race, 745
890+color, religion, disability, genetic information, marital status, sexual 746
891+orientation, primary language or immigration status, except to the 747
892+extent that a circumstance such as age, sex, pregnancy, medical 748
893+condition related to childbirth, preexisting medical condition or 749
894+physical or mental disability is medically significant to the provision of 750
895+appropriate medical care to the patient. Each hospital shall adopt a 751
896+policy to implement the provisions of this section. 752
897+(b) Unless otherwise permitted by contract, each hospital shall 753
898+prohibit each physician who serves on an on-call basis in the hospital's 754
899+emergency department from refusing to respond to a call on the basis of 755
900+the person's ethnicity, citizenship, age, preexisting medical condition, 756
901+insurance status, economic status, ability to pay for medical services, 757
902+sex, race, color, religion, disability, current medical condition, genetic 758
903+Committee Bill No. 7
904+
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907+
908+information, marital status, sexual orientation, primary language or 759
909+immigration status, except to the extent that a circumstance such as age, 760
910+sex, preexisting medical condition or physical or mental disability is 761
911+medically significant to the provision of appropriate medical care to the 762
912+patient. If a contract that was in existence on or before July 1, 2025, 763
913+between a physician and hospital for the provision of emergency 764
914+department coverage prevents a hospital from imposing the prohibition 765
915+required under this subsection, the contract shall be revised to include 766
916+such prohibition as soon as it is legally permissible to make such a 767
917+revision. Nothing in this section shall be construed to require any 768
918+physician to serve on an on-call basis for a hospital. 769
919+Sec. 13. (NEW) (Effective July 1, 2025) (a) Any individual harmed by a 770
920+violation of any provision of sections 4 to 12, inclusive, of this act may 771
921+bring, not later than one hundred eighty days after the occurrence of 772
922+such violation, a civil action against a hospital or other health care entity 773
923+for such violation. 774
924+(b) Any hospital or other health care entity found to have violated 775
925+any provision of sections 4 to 12, inclusive, of this act shall be liable for 776
926+compensatory damages, with costs and such reasonable attorney's fees 777
927+as may be allowed by the court. In the case of a health care provider who 778
928+has been subjected to retaliation or other disciplinary action in violation 779
929+of any provision of sections 4 to 12, inclusive, of this act, the hospital or 780
930+other health care entity shall also be liable for the full amount of gross 781
931+loss of wages in addition to any compensatory damages for which the 782
932+hospital or health care entity is liable under this subsection. 783
933+(c) The court may also provide injunctive relief to prevent further 784
934+violations of any provision of sections 4 to 12, inclusive, of this act. 785
935+(d) If the court determines that an action for damages was brought 786
936+under this section without substantial justification, the court may award 787
937+costs and reasonable attorney's fees to the hospital or other health care 788
938+entity. 789
939+Committee Bill No. 7
940+
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943+
944+(e) Nothing in this section shall preclude any other causes of action 790
945+authorized by law or prevent the state or any professional licensing 791
946+board from taking any action authorized by the general statutes against 792
947+the hospital, health care entity or an individual health care provider. 793
948+Sec. 14. (Effective from passage) The Health Care Cabinet established 794
949+pursuant to section 19a-725 of the general statutes shall study the 795
950+feasibility of regulating stop loss policies used in conjunction with 796
951+health plans as fully insured health plans. The cabinet shall hold one or 797
952+more informational hearings as part of such study. Not later than 798
953+January 1, 2026, the Commissioner of Health Strategy shall report, in 799
954+accordance with the provisions of section 11-4a of the general statutes, 800
955+to the joint standing committees of the General Assembly having 801
956+cognizance of matters relating to insurance and public health regarding 802
957+the results of such study. 803
958+Sec. 15. Section 19a-639 of the general statutes is repealed and the 804
959+following is substituted in lieu thereof (Effective July 1, 2025): 805
960+(a) In any deliberations involving a certificate of need application 806
961+filed pursuant to section 19a-638, the unit shall take into consideration 807
962+and make written findings concerning each of the following guidelines 808
963+and principles: 809
964+(1) Whether the proposed project is consistent with any applicable 810
965+policies and standards adopted in regulations by the Office of Health 811
966+Strategy; 812
967+(2) The relationship of the proposed project to the state-wide health 813
968+care facilities and services plan; 814
969+(3) Whether there is a clear public need for the health care facility or 815
970+services proposed by the applicant; 816
971+(4) Whether the applicant has satisfactorily demonstrated how the 817
972+proposal will impact the financial strength of the health care system in 818
973+the state or that the proposal is financially feasible for the applicant; 819
974+Committee Bill No. 7
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978+
979+(5) Whether the applicant has satisfactorily demonstrated how the 820
980+proposal will improve quality, accessibility and cost effectiveness of 821
981+health care delivery in the region, including, but not limited to, 822
982+provision of or any change in the access to services for Medicaid 823
983+recipients and indigent persons; 824
984+(6) The applicant's past and proposed provision of health care 825
985+services to relevant patient populations and payer mix, including, but 826
986+not limited to, access to services by Medicaid recipients and indigent 827
987+persons; 828
988+(7) Whether the applicant has satisfactorily identified the population 829
989+to be served by the proposed project and satisfactorily demonstrated 830
990+that the identified population has a need for the proposed services; 831
991+(8) The utilization of existing health care facilities and health care 832
992+services in the service area of the applicant; 833
993+(9) Whether the applicant has satisfactorily demonstrated that the 834
994+proposed project shall not result in an unnecessary duplication of 835
995+existing or approved health care services or facilities; 836
996+(10) Whether an applicant, who has failed to provide or reduced 837
997+access to services by Medicaid recipients or indigent persons, has 838
998+demonstrated good cause for doing so, which shall not be demonstrated 839
999+solely on the basis of differences in reimbursement rates between 840
1000+Medicaid and other health care payers; 841
1001+(11) Whether the applicant has satisfactorily demonstrated that the 842
1002+proposal will not negatively impact the diversity of health care 843
1003+providers and patient choice in the geographic region; and 844
1004+(12) Whether the applicant has satisfactorily demonstrated that any 845
1005+consolidation resulting from the proposal will not adversely affect 846
1006+health care costs or accessibility to care. 847
1007+[(b) In deliberations as described in subsection (a) of this section, 848
1008+Committee Bill No. 7
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1012+
1013+there shall be a presumption in favor of approving the certificate of need 849
1014+application for a transfer of ownership of a large group practice, as 850
1015+described in subdivision (3) of subsection (a) of section 19a-638, when 851
1016+an offer was made in response to a request for proposal or similar 852
1017+voluntary offer for sale.] 853
1018+[(c)] (b) The unit, as it deems necessary, may revise or supplement the 854
1019+guidelines and principles, set forth in subsection (a) of this section, 855
1020+through regulation. 856
1021+[(d)] (c) (1) For purposes of this subsection and subsection [(e)] (d) of 857
1022+this section: 858
1023+(A) "Affected community" means a municipality where a hospital is 859
1024+physically located or a municipality whose inhabitants are regularly 860
1025+served by a hospital; 861
1026+(B) "Hospital" has the same meaning as provided in section 19a-490; 862
1027+(C) "New hospital" means a hospital as it exists after the approval of 863
1028+an agreement pursuant to section 19a-486b, as amended by this act, or a 864
1029+certificate of need application for a transfer of ownership of a hospital; 865
1030+(D) "Purchaser" means a person who is acquiring, or has acquired, 866
1031+any assets of a hospital through a transfer of ownership of a hospital; 867
1032+(E) "Transacting party" means a purchaser and any person who is a 868
1033+party to a proposed agreement for transfer of ownership of a hospital; 869
1034+(F) "Transfer" means to sell, transfer, lease, exchange, option, convey, 870
1035+give or otherwise dispose of or transfer control over, including, but not 871
1036+limited to, transfer by way of merger or joint venture not in the ordinary 872
1037+course of business; and 873
1038+(G) "Transfer of ownership of a hospital" means a transfer that 874
1039+impacts or changes the governance or controlling body of a hospital, 875
1040+including, but not limited to, all affiliations, mergers or any sale or 876
1041+Committee Bill No. 7
1042+
1043+
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1045+
1046+transfer of net assets of a hospital and for which a certificate of need 877
1047+application or a certificate of need determination letter is filed on or after 878
1048+December 1, 2015. 879
1049+(2) In any deliberations involving a certificate of need application 880
1050+filed pursuant to section 19a-638 that involves the transfer of ownership 881
1051+of a hospital, the unit shall, in addition to the guidelines and principles 882
1052+set forth in subsection (a) of this section and those prescribed through 883
1053+regulation pursuant to subsection [(c)] (b) of this section, take into 884
1054+consideration and make written findings concerning each of the 885
1055+following guidelines and principles: 886
1056+(A) Whether the applicant fairly considered alternative proposals or 887
1057+offers in light of the purpose of maintaining health care provider 888
1058+diversity and consumer choice in the health care market and access to 889
1059+affordable quality health care for the affected community; and 890
1060+(B) Whether the plan submitted pursuant to section 19a-639a 891
1061+demonstrates, in a manner consistent with this chapter, how health care 892
1062+services will be provided by the new hospital for the first three years 893
1063+following the transfer of ownership of the hospital, including any 894
1064+consolidation, reduction, elimination or expansion of existing services 895
1065+or introduction of new services. 896
1066+(3) The unit shall deny any certificate of need application involving a 897
1067+transfer of ownership of a hospital unless the commissioner finds that 898
1068+the affected community will be assured of continued access to high 899
1069+quality and affordable health care after accounting for any proposed 900
1070+change impacting hospital staffing. 901
1071+(4) The unit may deny any certificate of need application involving a 902
1072+transfer of ownership of a hospital subject to a cost and market impact 903
1073+review pursuant to section 19a-639f, as amended by this act, if the 904
1074+commissioner finds that (A) the affected community will not be assured 905
1075+of continued access to high quality and affordable health care after 906
1076+accounting for any consolidation in the hospital and health care market 907
1077+Committee Bill No. 7
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1081+
1082+that may lessen health care provider diversity, consumer choice and 908
1083+access to care, and (B) any likely increases in the prices for health care 909
1084+services or total health care spending in the state may negatively impact 910
1085+the affordability of care. 911
1086+(5) The unit may place any conditions on the approval of a certificate 912
1087+of need application involving a transfer of ownership of a hospital 913
1088+consistent with the provisions of this chapter. Before placing any such 914
1089+conditions, the unit shall weigh the value of such conditions in 915
1090+promoting the purposes of this chapter against the individual and 916
1091+cumulative burden of such conditions on the transacting parties and the 917
1092+new hospital. For each condition imposed, the unit shall include a 918
1093+concise statement of the legal and factual basis for such condition and 919
1094+the provision or provisions of this chapter that it is intended to promote. 920
1095+Each condition shall be reasonably tailored in time and scope. The 921
1096+transacting parties or the new hospital shall have the right to make a 922
1097+request to the unit for an amendment to, or relief from, any condition 923
1098+based on changed circumstances, hardship or for other good cause. 924
1099+[(e)] (d) (1) If the certificate of need application (A) involves the 925
1100+transfer of ownership of a hospital, (B) the purchaser is a hospital, as 926
1101+defined in section 19a-490, whether located within or outside the state, 927
1102+that had net patient revenue for fiscal year 2013 in an amount greater 928
1103+than one billion five hundred million dollars or a hospital system, as 929
1104+defined in section 19a-486i, whether located within or outside the state, 930
1105+that had net patient revenue for fiscal year 2013 in an amount greater 931
1106+than one billion five hundred million dollars, or any person that is 932
1107+organized or operated for profit, and (C) such application is approved, 933
1108+the unit shall hire an independent consultant to serve as a post-transfer 934
1109+compliance reporter for a period of three years after completion of the 935
1110+transfer of ownership of the hospital. Such reporter shall, at a minimum: 936
1111+(i) Meet with representatives of the purchaser, the new hospital and 937
1112+members of the affected community served by the new hospital not less 938
1113+than quarterly; and (ii) report to the unit not less than quarterly 939
1114+concerning (I) efforts the purchaser and representatives of the new 940
1115+Committee Bill No. 7
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1120+hospital have taken to comply with any conditions the unit placed on 941
1121+the approval of the certificate of need application and plans for future 942
1122+compliance, and (II) community benefits and uncompensated care 943
1123+provided by the new hospital. The purchaser shall give the reporter 944
1124+access to its records and facilities for the purposes of carrying out the 945
1125+reporter's duties. The purchaser shall hold a public hearing in the 946
1126+municipality in which the new hospital is located not less than annually 947
1127+during the reporting period to provide for public review and comment 948
1128+on the reporter's reports and findings. 949
1129+(2) If the reporter finds that the purchaser has breached a condition 950
1130+of the approval of the certificate of need application, the unit may, in 951
1131+consultation with the purchaser, the reporter and any other interested 952
1132+parties it deems appropriate, implement a performance improvement 953
1133+plan designed to remedy the conditions identified by the reporter and 954
1134+continue the reporting period for up to one year following a 955
1135+determination by the unit that such conditions have been resolved. 956
1136+(3) The purchaser shall provide funds, in an amount determined by 957
1137+the unit not to exceed two hundred thousand dollars annually, for the 958
1138+hiring of the post-transfer compliance reporter. 959
1139+[(f)] (e) Nothing in subsection [(d)] (c) or [(e)] (d) of this section shall 960
1140+apply to a transfer of ownership of a hospital in which either a certificate 961
1141+of need application is filed on or before December 1, 2015, or where a 962
1142+certificate of need determination letter is filed on or before December 1, 963
1143+2015. 964
1144+Sec. 16. Subsection (b) of section 19a-486b of the general statutes is 965
1145+repealed and the following is substituted in lieu thereof (Effective July 1, 966
1146+2025): 967
1147+(b) The commissioner and the Attorney General may place any 968
1148+conditions on the approval of an application that relate to the purposes 969
1149+of sections 19a-486a to 19a-486h, inclusive. In placing any such 970
1150+conditions the commissioner shall follow the guidelines and criteria 971
1151+Committee Bill No. 7
1152+
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1155+
1156+described in subdivision (4) of subsection [(d)] (c) of section 19a-639, as 972
1157+amended by this act. Any such conditions may be in addition to any 973
1158+conditions placed by the commissioner pursuant to subdivision (4) of 974
1159+subsection [(d)] (c) of section 19a-639, as amended by this act. 975
1160+Sec. 17. Subsection (d) of section 19a-639f of the general statutes is 976
1161+repealed and the following is substituted in lieu thereof (Effective July 1, 977
1162+2025): 978
1163+(d) The cost and market impact review conducted pursuant to this 979
1164+section shall examine factors relating to the businesses and relative 980
1165+market positions of the transacting parties as defined in subsection [(d)] 981
1166+(c) of section 19a-639, as amended by this act, and may include, but need 982
1167+not be limited to: (1) The transacting parties' size and market share 983
1168+within its primary service area, by major service category and within its 984
1169+dispersed service areas; (2) the transacting parties' prices for services, 985
1170+including the transacting parties' relative prices compared to other 986
1171+health care providers for the same services in the same market; (3) the 987
1172+transacting parties' health status adjusted total medical expense, 988
1173+including the transacting parties' health status adjusted total medical 989
1174+expense compared to that of similar health care providers; (4) the quality 990
1175+of the services provided by the transacting parties, including patient 991
1176+experience; (5) the transacting parties' cost and cost trends in 992
1177+comparison to total health care expenditures state wide; (6) the 993
1178+availability and accessibility of services similar to those provided by 994
1179+each transacting party, or proposed to be provided as a result of the 995
1180+transfer of ownership of a hospital within each transacting party's 996
1181+primary service areas and dispersed service areas; (7) the impact of the 997
1182+proposed transfer of ownership of the hospital on competing options for 998
1183+the delivery of health care services within each transacting party's 999
1184+primary service area and dispersed service area including the impact on 1000
1185+existing service providers; (8) the methods used by the transacting 1001
1186+parties to attract patient volume and to recruit or acquire health care 1002
1187+professionals or facilities; (9) the role of each transacting party in serving 1003
1188+at-risk, underserved and government payer patient populations, 1004
1189+Committee Bill No. 7
1190+
1191+
1192+LCO No. 6182 34 of 46
1193+
1194+including those with behavioral, substance use disorder and mental 1005
1195+health conditions, within each transacting party's primary service area 1006
1196+and dispersed service area; (10) the role of each transacting party in 1007
1197+providing low margin or negative margin services within each 1008
1198+transacting party's primary service area and dispersed service area; (11) 1009
1199+consumer concerns, including, but not limited to, complaints or other 1010
1200+allegations that a transacting party has engaged in any unfair method of 1011
1201+competition or any unfair or deceptive act or practice; and (12) any other 1012
1202+factors that the unit determines to be in the public interest. 1013
1203+Sec. 18. Subsection (j) of section 19a-639f of the general statutes is 1014
1204+repealed and the following is substituted in lieu thereof (Effective July 1, 1015
1205+2025): 1016
1206+(j) The unit shall retain an independent consultant with expertise on 1017
1207+the economic analysis of the health care market and health care costs 1018
1208+and prices to conduct each cost and market impact review, as described 1019
1209+in this section. The unit shall submit bills for such services to the 1020
1210+purchaser, as defined in subsection [(d)] (c) of section 19a-639, as 1021
1211+amended by this act. Such purchaser shall pay such bills not later than 1022
1212+thirty days after receipt. Such bills shall not exceed two hundred 1023
1213+thousand dollars per application. The provisions of chapter 57, sections 1024
1214+4-212 to 4-219, inclusive, and section 4e-19 shall not apply to any 1025
1215+agreement executed pursuant to this subsection. 1026
1216+Sec. 19. (NEW) (Effective July 1, 2025) (a) As used in this section: 1027
1217+(1) "Collateral costs" means any out-of-pocket costs, other than the 1028
1218+cost of the procedure itself, necessary to receive reproductive health care 1029
1219+services in the state, including, but not limited to, costs for travel, 1030
1220+lodging and meals; 1031
1221+(2) "Gender-affirming health care services" has the same meaning as 1032
1222+provided in section 52-571n of the general statutes; 1033
1223+(3) "Health care provider" means any person licensed under the 1034
1224+Committee Bill No. 7
1225+
1226+
1227+LCO No. 6182 35 of 46
1228+
1229+provisions of federal or state law to provide health care services; 1035
1230+(4) "Nonprofit organization" means an organization that is exempt 1036
1231+from taxation pursuant to Section 501(c)(3) of the Internal Revenue Code 1037
1232+of 1986, or any subsequent corresponding internal revenue code of the 1038
1233+United States, as amended from time to time; 1039
1234+(5) "Patient-identifiable data" means any information that identifies, 1040
1235+or may reasonably be used as a basis to identify, an individual patient; 1041
1236+(6) "Qualified person" means a person who is a resident of a state that 1042
1237+has enacted laws that limit such person's access to reproductive health 1043
1238+care services or gender-affirming health care services; and 1044
1239+(7) "Reproductive health care services" means all medical, surgical, 1045
1240+counseling or referral services relating to the human reproductive 1046
1241+system, including, but not limited to, services relating to fertility, 1047
1242+pregnancy, contraception and abortion. 1048
1243+(b) There is established an account to be known as the "safe harbor 1049
1244+account", which shall be a separate, nonlapsing account of the State 1050
1245+Treasurer. The account shall contain any moneys required by law to be 1051
1246+deposited in the account and any funds received from any public or 1052
1247+private contributions, gifts, grants, donations, bequests or devises to the 1053
1248+account. Moneys in the account shall be expended by the board of 1054
1249+trustees, established pursuant to subsection (c) of this section, for the 1055
1250+purposes of providing grants to (1) health care providers who provide 1056
1251+reproductive health care services or gender-affirming health care 1057
1252+services, (2) nonprofit organizations whose mission includes providing 1058
1253+funding for reproductive health care services or the collateral costs 1059
1254+incurred by qualified persons to receive such services in the state, or (3) 1060
1255+nonprofit organizations that serve LGBTQ+ youth or families in the 1061
1256+state for the purpose of reimbursing or paying for collateral costs 1062
1257+incurred by qualified persons to receive reproductive health care 1063
1258+services or gender-affirming health care services. 1064
1259+Committee Bill No. 7
1260+
1261+
1262+LCO No. 6182 36 of 46
1263+
1264+(c) The safe harbor account shall be administered by a board of 1065
1265+trustees consisting of the following members: 1066
1266+(1) The Treasurer, or the Treasurer's designee, who shall serve as 1067
1267+chairperson of the board of trustees; 1068
1268+(2) The Commissioner of Mental Health and Addiction Services, or 1069
1269+the commissioner's designee; 1070
1270+(3) The Commissioner of Social Services, or the commissioner's 1071
1271+designee; 1072
1272+(4) The Commissioner of Public Health, or the commissioner's 1073
1273+designee; and 1074
1274+(5) Five members appointed by the Treasurer, (A) one of whom shall 1075
1275+be a provider of reproductive health care services in the state, (B) one of 1076
1276+whom shall have experience working with members of the LGBTQ+ 1077
1277+community, and (C) one of whom shall have experience working with 1078
1278+providers of reproductive health care services. When making such 1079
1279+appointments, the Treasurer shall use the Treasurer's best efforts to 1080
1280+ensure that the board of trustees reflects the racial, gender and 1081
1281+geographic diversity of the state. 1082
1282+(d) Not later than September 1, 2025, the board of trustees shall adopt 1083
1283+policies and procedures concerning the awarding of grants pursuant to 1084
1284+the provisions of this section. Such policies and procedures shall 1085
1285+include, but need not be limited to, (1) grant application procedures, (2) 1086
1286+eligibility criteria for applicants, (3) eligibility criteria for collateral costs, 1087
1287+(4) consideration of need, including, but not limited to, financial need, 1088
1288+of the applicant, and (5) procedures to coordinate with any national 1089
1289+network created to perform similar functions to those of the safe harbor 1090
1290+account, including, but not limited to, procedures for the acceptance of 1091
1291+funding transferred to the safe harbor account for a particular use. Such 1092
1292+policies and procedures shall not require the collection or retention of 1093
1293+patient-identifiable data in order to receive a grant. Such policies and 1094
1294+Committee Bill No. 7
1295+
1296+
1297+LCO No. 6182 37 of 46
1298+
1299+procedures may be updated as deemed necessary by the board of 1095
1300+trustees. In the event that the board of trustees determines that the 1096
1301+policies and procedures adopted pursuant to the provisions of this 1097
1302+subsection are inadequate with respect to (A) determining the eligibility 1098
1303+of a certain health care provider or nonprofit organization for a grant, 1099
1304+or (B) whether a certain health care service received by a qualified 1100
1305+person or collateral cost incurred by a qualified person is eligible to be 1101
1306+reimbursed or paid by a health care provider or nonprofit organization 1102
1307+using grant moneys received pursuant to this section, the board of 1103
1308+trustees may make a fact-based determination as to such eligibility. 1104
1309+Sec. 20. (NEW) (Effective from passage) It is hereby declared that opioid 1105
1310+use disorder constitutes a public health crisis in this state and will 1106
1311+continue to constitute a public health crisis until each goal reported by 1107
1312+the Connecticut Alcohol and Drug Policy Council pursuant to 1108
1313+subsection (f) of section 17a-667a of the general statutes, as amended by 1109
1314+this act, is attained. 1110
1315+Sec. 21. Section 17a-667a of the general statutes is amended by adding 1111
1316+subsection (f) as follows (Effective from passage): 1112
1317+(NEW) (f) The Connecticut Alcohol and Drug Policy Council shall 1113
1318+convene a working group to establish one or more goals for the state to 1114
1319+achieve in its efforts to combat the prevalence opioid use disorder in the 1115
1320+state. Not later than January 1, 2026, the council shall report, in 1116
1321+accordance with the provisions of section 11-4a, to the joint standing 1117
1322+committee of the General Assembly having cognizance of matters 1118
1323+relating to public health regarding each goal established by the working 1119
1324+group. 1120
1325+Sec. 22. (Effective from passage) (a) As used in this section: 1121
1326+(1) "Priority school district" has the same meaning as described in 1122
1327+section 10-266p of the general statutes; and 1123
1328+(2) "Geofence" means any technology that uses global positioning 1124
1329+Committee Bill No. 7
1330+
1331+
1332+LCO No. 6182 38 of 46
1333+
1334+coordinates, cell tower connectivity, cellular data, radio frequency 1125
1335+identification, wireless fidelity technology data or any other form of 1126
1336+location detection, or any combination of such coordinates, connectivity, 1127
1337+data, identification or other form of location detection, to establish a 1128
1338+virtual boundary. 1129
1339+(b) Not later than January 1, 2026, the Department of Education, in 1130
1340+collaboration with the Department of Mental Health and Addiction 1131
1341+Services, shall establish a mental and behavioral health awareness and 1132
1342+treatment pilot program in priority school districts. The program shall 1133
1343+enable not less than one hundred thousand students in such districts to 1134
1344+utilize an electronic mental and behavioral health awareness and 1135
1345+treatment tool through an Internet web site, online service or mobile 1136
1346+application, which tool shall be selected by the Commissioners of 1137
1347+Education and Mental Health and Addiction Services and provide each 1138
1348+of the following: 1139
1349+(1) Mental and behavioral health education resources to promote 1140
1350+awareness and understanding of mental and behavioral health issues; 1141
1351+(2) Peer-to-peer support services, including, but not limited to, a 1142
1352+moderated online peer chat room, where comments submitted by 1143
1353+students for posting in the chat room are prescreened and filtered 1144
1354+through by a moderator prior to posting, to encourage social connection 1145
1355+and mutual support among students; and 1146
1356+(3) Private online sessions with mental or behavioral health care 1147
1357+providers licensed in the state who (A) have demonstrated experience 1148
1358+delivering mental or behavioral health care services to school districts 1149
1359+serving both rural and urban student populations, and (B) shall be 1150
1360+selected or approved by the Commissioner of Mental Health and 1151
1361+Addiction Services, provided such sessions comply with the provisions 1152
1362+of section 19a-906 of the general statutes concerning telehealth and the 1153
1363+provisions of section 19a-14c of the general statutes concerning the 1154
1364+provision of outpatient mental health treatment to minors. 1155
1365+Committee Bill No. 7
1366+
1367+
1368+LCO No. 6182 39 of 46
1369+
1370+(c) (1) During its first year of operation, the pilot program shall have 1156
1371+the following objectives: (A) To build partnerships between priority 1157
1372+school districts and community organizations providing mental and 1158
1373+behavioral health care services; and (B) to launch a digital marketing 1159
1374+campaign using tools, including, but not limited to, a geofence, to raise 1160
1375+awareness and engagement among students concerning mental and 1161
1376+behavioral health issues affecting students. 1162
1377+(2) Not later than January 1, 2026, the Commissioners of Education 1163
1378+and Mental Health and Addiction Services shall jointly report, in 1164
1379+accordance with the provisions of section 11-4a of the general statutes, 1165
1380+regarding the program's success in achieving such objectives to the joint 1166
1381+standing committees of the General Assembly having cognizance of 1167
1382+matters relating to public health and education. 1168
1383+(d) (1) During its second year of operation, the pilot program shall 1169
1384+have the following objectives: (A) To refer students to mental and 1170
1385+behavioral health care providers, as needed; and (B) to enhance 1171
1386+students' engagement with mental and behavioral health tools, 1172
1387+including, but not limited to, coping strategies and clinician support. 1173
1388+(2) Not later than January 1, 2027, the Commissioners of Education 1174
1389+and Mental Health and Addiction Services shall jointly report, in 1175
1390+accordance with the provisions of section 11-4a of the general statutes, 1176
1391+regarding the program's success in achieving such objectives to the joint 1177
1392+standing committees of the General Assembly having cognizance of 1178
1393+matters relating to public health and education. 1179
1394+Sec. 23. (Effective from passage) The sum of three million six hundred 1180
1395+thousand dollars is appropriated to the Department of Education from 1181
1396+the General Fund, for the fiscal year ending June 30, 2026, for the 1182
1397+administration of the mental and behavioral health awareness and 1183
1398+treatment pilot program established pursuant to section 22 of this act. 1184
1399+Sec. 24. (NEW) (Effective from passage) There is established an account 1185
1400+to be known as the "public health urgent communication account", 1186
1401+Committee Bill No. 7
1402+
1403+
1404+LCO No. 6182 40 of 46
1405+
1406+which shall be a separate, nonlapsing account. The account shall contain 1187
1407+any moneys required by law to be deposited in the account. Moneys in 1188
1408+the account shall be expended by the Department of Public Health for 1189
1409+the purposes of providing timely, effective communication to members 1190
1410+of the general public, health care providers and other relevant 1191
1411+stakeholders during a public health emergency, as described in section 1192
1412+19a-131a of the general statutes. 1193
1413+Sec. 25. (Effective from passage) The sum of five million dollars is 1194
1414+appropriated to the Department of Public Health from the General 1195
1415+Fund, for the fiscal year ending June 30, 2026, for deposit into the "public 1196
1416+health urgent communication account" established pursuant to section 1197
1417+24 of this act. 1198
1418+Sec. 26. (NEW) (Effective from passage) There is established an account 1199
1419+to be known as the "emergency public health financial safeguard 1200
1420+account", which shall be a separate, nonlapsing account. The account 1201
1421+shall contain any moneys required by law to be deposited in the account. 1202
1422+Moneys in the account shall be expended by the Department of Public 1203
1423+Health for the purposes of addressing unexpected shortfalls in public 1204
1424+health funding and ensuring the Department of Public Health's ability 1205
1425+to respond to the health care needs of state residents and provide a 1206
1426+continuity of essential public health services. 1207
1427+Sec. 27. (Effective from passage) The sum of thirty million dollars is 1208
1428+appropriated to the Department of Public Health from the General 1209
1429+Fund, for the fiscal year ending June 30, 2026, for deposit into the 1210
1430+"emergency public health financial safeguard account" established 1211
1431+pursuant to section 26 of this act. 1212
1432+Sec. 28. (NEW) (Effective October 1, 2025) (a) As used in this section 1213
1433+and sections 29 to 31, inclusive, of this act: 1214
1434+(1) "Commissioner" means the Commissioner of Public Health; 1215
1435+(2) "Department" means the Department of Public Health; 1216
1436+Committee Bill No. 7
1437+
1438+
1439+LCO No. 6182 41 of 46
1440+
1441+(3) "Health care administrator" means a person employed by a 1217
1442+hospital who is a: 1218
1443+(A) Nonclinical hospital manager with direct supervisory authority 1219
1444+over clinical health care providers who is responsible for one or more of 1220
1445+the following activities: 1221
1446+(i) Hiring, scheduling, evaluating and providing direct supervision 1222
1447+of clinical health care providers; 1223
1448+(ii) Monitoring hospital activities for compliance with state or federal 1224
1449+regulatory requirements; or 1225
1450+(iii) Developing fiscal reports for clinical units of the hospital or the 1226
1451+hospital as a whole; or 1227
1452+(B) Nonclinical hospital director, officer or executive who has direct 1228
1453+or indirect supervisory authority over only nonclinical hospital 1229
1454+managers described in subparagraph (A) of this subdivision, for one or 1230
1455+more of the following activities: 1231
1456+(i) Hiring and supervising such nonclinical hospital managers; 1232
1457+(ii) Providing oversight of operations for the hospital or any of its 1233
1458+departments; 1234
1459+(iii) Developing policies and procedures establishing the standards of 1235
1460+patient care; 1236
1461+(iv) Providing oversight of budgetary and financial decisions related 1237
1462+to operations and the delivery of patient care for the hospital or any of 1238
1463+its departments; and 1239
1464+(v) Ensuring that hospital policies comply with state and federal 1240
1465+regulatory requirements; and 1241
1466+(4) "Hospital" means an institution licensed as a hospital pursuant to 1242
1467+chapter 368v of the general statutes. 1243
1468+Committee Bill No. 7
1469+
1470+
1471+LCO No. 6182 42 of 46
1472+
1473+Sec. 29. (NEW) (Effective October 1, 2025) (a) No person shall practice 1244
1474+as a health care administrator unless such person is licensed pursuant 1245
1475+to section 30 of this act. 1246
1476+(b) No person may use the title "health care administrator" or make 1247
1477+use of any title, words, letters or abbreviations indicating or implying 1248
1478+that such person is licensed to practice as a health care administrator 1249
1479+pursuant to section 30 of this act. 1250
1480+Sec. 30. (NEW) (Effective October 1, 2025) (a) Except as provided in 1251
1481+subsection (b) of this section, the commissioner shall grant a license to 1252
1482+practice as a health care administrator to an applicant who presents 1253
1483+evidence satisfactory to the commissioner that such applicant has: (1) A 1254
1484+baccalaureate or graduate degree in health care administration, public 1255
1485+health or a related field from a regionally accredited institution of higher 1256
1486+education, or from an institution of higher education outside of the 1257
1487+United States that is legally chartered to grant postsecondary degrees in 1258
1488+the country in which such institution is located; (2) passed an 1259
1489+examination prescribed by the department designed to test the 1260
1490+applicant's knowledge of health care laws, patient safety protocols and 1261
1491+health-related ethical guidelines; and (3) submitted a completed 1262
1492+application in a form and manner prescribed by the department. The fee 1263
1493+for an initial license under this section shall be two hundred dollars. 1264
1494+(b) The department may grant licensure without examination, subject 1265
1495+to payment of fees with respect to the initial application, to any 1266
1496+applicant who is currently licensed or certified as a health care 1267
1497+administrator in another state, territory or commonwealth of the United 1268
1498+States, provided such state, territory or commonwealth maintains 1269
1499+licensure or certification standards that, in the opinion of the 1270
1500+department, are equivalent to or higher than the standards of this state. 1271
1501+No license shall be issued under this section to any applicant against 1272
1502+whom professional disciplinary action is pending or who is the subject 1273
1503+of an unresolved complaint. 1274
1504+(c) A license issued to a health care administrator under this section 1275
1505+Committee Bill No. 7
1506+
1507+
1508+LCO No. 6182 43 of 46
1509+
1510+may be renewed annually in accordance with the provisions of section 1276
1511+19a-88 of the general statutes, as amended by this act. The fee for such 1277
1512+renewal shall be one hundred five dollars. Each licensed health care 1278
1513+administrator applying for license renewal shall furnish evidence 1279
1514+satisfactory to the commissioner of having participated in continuing 1280
1515+education programs prescribed by the department. The commissioner 1281
1516+shall adopt regulations, in accordance with chapter 54 of the general 1282
1517+statutes, to (1) define basic requirements for continuing education 1283
1518+programs, (2) delineate qualifying programs, (3) establish a system of 1284
1519+control and reporting, and (4) provide for waiver of the continuing 1285
1520+education requirement for good cause. 1286
1521+Sec. 31. (NEW) (Effective October 1, 2025) (a) The department shall 1287
1522+have jurisdiction to hear all charges of unacceptable conduct brought 1288
1523+against a person licensed to practice as a health care administrator. The 1289
1524+commissioner shall provide written notice of such hearing to such 1290
1525+person not later than thirty days prior to such hearing. After holding 1291
1526+such hearing, the department may take any of the actions set forth in 1292
1527+section 19a-17 of the general statutes, if it finds that any grounds for 1293
1528+action by the department enumerated in subsection (b) of this section 1294
1529+exist. Any person aggrieved by the finding of the department may 1295
1530+appeal such finding in accordance with the provisions of section 4-183 1296
1531+of the general statutes, and such appeal shall have precedence over 1297
1532+nonprivileged cases in respect to order of trial. 1298
1533+(b) The department may take action under section 19a-17 for any of 1299
1534+the following reasons: (1) A fiscal or operational decision that results in 1300
1535+injury to a patient or creates an unreasonable risk that a patient may be 1301
1536+harmed; (2) a violation by a licensed health care provider of a state or 1302
1537+federal statute or administrative rule regulating a profession when the 1303
1538+health care administrator was responsible for the oversight of the 1304
1539+licensed health care provider; (3) aiding or abetting a licensed health 1305
1540+care provider to practice the provider's health care profession after a 1306
1541+patient complaint or adverse event has been reported to the hospital 1307
1542+employing the licensed health care administrator, the department or the 1308
1543+Committee Bill No. 7
1544+
1545+
1546+LCO No. 6182 44 of 46
1547+
1548+appropriate disciplining authority, while the complaint or adverse 1309
1549+event is being investigated, and if harm, disability or death of a patient 1310
1550+occurred after the complaint or report of the adverse event; (4) failure to 1311
1551+adequately supervise licensed clinical staff and nonclinical staff to the 1312
1552+extent that a patient's health or safety is at risk; (5) any administrative, 1313
1553+operational or fiscal decision that impedes a clinical licensed health care 1314
1554+provider from adhering to standards of practice or leads to patient 1315
1555+harm, disability or death; or (6) a fiscal or operational decision resulting 1316
1556+in the inability of licensed clinical health care providers to practice with 1317
1557+reasonable skill and safety, regardless of the occurrence of patient harm, 1318
1558+disability or death. The commissioner may order a license holder to 1319
1559+submit to a reasonable physical or mental examination if such license 1320
1560+holder's physical or mental capacity to practice safely is being 1321
1561+investigated. The commissioner may petition the superior court for the 1322
1562+judicial district of Hartford to enforce such order or any action taken 1323
1563+pursuant to section 19a-17. 1324
1564+Sec. 32. Subdivision (1) of subsection (e) of section 19a-88 of the 1325
1565+general statutes is repealed and the following is substituted in lieu 1326
1566+thereof (Effective October 1, 2025): 1327
1567+(e) (1) Each person holding a license or certificate issued under 1328
1568+section 30 of this act, section 19a-514, 20-65k, 20-74s, 20-185k, 20-185l, 20-1329
1569+195cc or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to 381a, 1330
1570+inclusive, 383 to 383c, inclusive, 383g, 384, 384a, 384b, 385, 393a, 395, 399 1331
1571+or 400a and section 20-206n or 20-206o shall, annually, or, in the case of 1332
1572+a person holding a license as a marital and family therapist associate 1333
1573+under section 20-195c on or before twenty-four months after the date of 1334
1574+initial licensure, during the month of such person's birth, apply for 1335
1575+renewal of such license or certificate to the Department of Public Health, 1336
1576+giving such person's name in full, such person's residence and business 1337
1577+address and such other information as the department requests. 1338
1578+Sec. 33. (NEW) (Effective July 1, 2025) (a) As used in this section: 1339
1579+(1) "Advanced practice registered nurse" means an individual 1340
1580+Committee Bill No. 7
1581+
1582+
1583+LCO No. 6182 45 of 46
1584+
1585+licensed as an advanced practice registered nurse pursuant to chapter 1341
1586+378 of the general statutes; 1342
1587+(2) "Physician" means an individual licensed as a physician pursuant 1343
1588+to chapter 370 of the general statutes; 1344
1589+(3) "Physician assistant" means an individual licensed as a physician 1345
1590+assistant pursuant to chapter 370 of the general statutes; and 1346
1591+(4) "Sudden unexpected death in epilepsy" means the death of a 1347
1592+person with epilepsy that is not caused by injury, drowning or other 1348
1593+known causes unrelated to epilepsy. 1349
1594+(b) On and after October 1, 2025, each physician, advanced practice 1350
1595+registered nurse and physician assistant who regularly treats patients 1351
1596+with epilepsy shall provide each such patient with information 1352
1597+concerning the risk of sudden unexpected death in epilepsy and 1353
1598+methods to mitigate such risk. 1354
8771599 This act shall take effect as follows and shall amend the following
8781600 sections:
8791601
880-Section 1 from passage 19a-38 Substitute Bill No. 7
881-
882-
883-LCO 26 of 26
884-
1602+Section 1 October 1, 2025 19a-38
8851603 Sec. 2 from passage New section
886-Sec. 3 July 1, 2025 New section
1604+Sec. 3 July 1, 2025 19a-508c
8871605 Sec. 4 July 1, 2025 New section
8881606 Sec. 5 July 1, 2025 New section
8891607 Sec. 6 July 1, 2025 New section
8901608 Sec. 7 July 1, 2025 New section
8911609 Sec. 8 July 1, 2025 New section
8921610 Sec. 9 July 1, 2025 New section
8931611 Sec. 10 July 1, 2025 New section
8941612 Sec. 11 July 1, 2025 New section
8951613 Sec. 12 July 1, 2025 New section
8961614 Sec. 13 July 1, 2025 New section
8971615 Sec. 14 from passage New section
898-Sec. 15 from passage 17a-667a(f)
899-Sec. 16 from passage New section
900-Sec. 17 from passage New section
901-Sec. 18 from passage New section
902-Sec. 19 from passage New section
1616+Sec. 15 July 1, 2025 19a-639
1617+Sec. 16 July 1, 2025 19a-486b(b)
1618+Sec. 17 July 1, 2025 19a-639f(d)
1619+Committee Bill No. 7
1620+
1621+
1622+LCO No. 6182 46 of 46
1623+
1624+Sec. 18 July 1, 2025 19a-639f(j)
1625+Sec. 19 July 1, 2025 New section
9031626 Sec. 20 from passage New section
904-Sec. 21 from passage New section
905-Sec. 22 October 1, 2025 New section
906-Sec. 23 October 1, 2025 New section
907-Sec. 24 October 1, 2025 New section
908-Sec. 25 October 1, 2025 New section
909-Sec. 26 October 1, 2025 19a-88(e)(1)
910-Sec. 27 July 1, 2025 New section
1627+Sec. 21 from passage 17a-667a(f)
1628+Sec. 22 from passage New section
1629+Sec. 23 from passage New section
1630+Sec. 24 from passage New section
1631+Sec. 25 from passage New section
1632+Sec. 26 from passage New section
1633+Sec. 27 from passage New section
1634+Sec. 28 October 1, 2025 New section
1635+Sec. 29 October 1, 2025 New section
1636+Sec. 30 October 1, 2025 New section
1637+Sec. 31 October 1, 2025 New section
1638+Sec. 32 October 1, 2025 19a-88(e)(1)
1639+Sec. 33 July 1, 2025 New section
9111640
912-Statement of Legislative Commissioners:
913-In Sec. 13(a)(1), "or gender-affirming health care services" was inserted
914-after "reproductive health care services" for consistency with the
915-provisions of subsection (b) of said section.
1641+Statement of Purpose:
1642+To protect continued access to health care and the equitable delivery of
1643+health care services in the state.
9161644
917-PH Joint Favorable Subst.
1645+[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
1646+that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
1647+underlined.]
1648+
1649+Co-Sponsors: SEN. LOONEY, 11th Dist.; SEN. DUFF, 25th Dist.
1650+SEN. ANWAR, 3rd Dist.; SEN. CABRERA, 17th Dist.
1651+SEN. COHEN, 12th Dist.; SEN. FLEXER, 29th Dist.
1652+SEN. GADKAR-WILCOX, 22nd Dist.; SEN. GASTON, 23rd Dist.
1653+SEN. HOCHADEL, 13th Dist.; SEN. HONIG, 8th Dist.
1654+SEN. KUSHNER, 24th Dist.; SEN. LESSER, 9th Dist.
1655+SEN. LOPES, 6th Dist.; SEN. MAHER, 26th Dist.
1656+SEN. MARONEY, 14th Dist.; SEN. MARX, 20th Dist.
1657+SEN. MCCRORY, 2nd Dist.; SEN. MILLER P., 27th Dist.
1658+SEN. NEEDLEMAN, 33rd Dist.; SEN. RAHMAN, 4th Dist.
1659+SEN. SLAP, 5th Dist.; SEN. WINFIELD, 10th Dist.
1660+
1661+
1662+
9181663