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General Assembly Substitute Bill No. 7
January Session, 2025
AN ACT CONCERNING PROTECTIONS FOR ACCESS TO HEALTH
CARE AND THE EQUITABLE DELIVERY OF HEALTH CARE
SERVICES IN THE STATE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-38 of the general statutes is repealed and the 1
following is substituted in lieu thereof (Effective from passage): 2
A water company, as defined in section 25-32a, shall add a measured 3
amount of fluoride to the water supply of any water system that it owns 4
and operates and that serves twenty thousand or more persons so as to 5
maintain an average monthly fluoride content that is not more or less 6
than [0.15 of a milligram per liter different than the United States 7
Department of Health and Human Services' most recent 8
recommendation for optimal fluoride levels in drinking water to 9
prevent tooth decay] 0.7 of a milligram of fluoride per liter of water 10
provided such average monthly fluoride content shall not deviate 11
greater or less than 0.15 of a milligram per liter. 12
Sec. 2. (NEW) (Effective from passage) (a) The Commissioner of Public 13
Health may establish an advisory committee to advise the commissioner 14
on matters relating to recommendations by the Centers for Disease 15
Control and Prevention and the federal Food and Drug Administration 16
using evidence-based data from peer-reviewed literature and studies. 17 Substitute Bill No. 7
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(b) The advisory committee may include, but need not be limited to, 18
the following members: 19
(1) The dean of a school of public health at an independent institution 20
of higher education in the state; 21
(2) The dean of a school of public health at a public institution of 22
higher education in the state; 23
(3) A physician specializing in primary care who (A) has not less than 24
ten years of clinical practice experience, and (B) is a professor at a 25
medical school in the state; 26
(4) An infectious disease specialist who (A) has not less than ten years 27
of clinical practice experience, and (B) is a professor at an institution of 28
higher education in the state; 29
(5) A pediatrician who (A) has not less than ten years of clinical 30
practice experience and expertise in children's health and vaccinations, 31
and (B) is a professor at an institution of higher education in the state; 32
and 33
(6) Any other individuals determined to be a beneficial member of 34
the advisory committee by the Commissioner of Public Health. 35
(c) The advisory committee shall serve in a nonbinding advisory 36
capacity, providing guidance solely at the discretion of the 37
Commissioner of Public Health. 38
Sec. 3. (NEW) (Effective July 1, 2025) (a) As used in this section: 39
(1) "Emergency medical condition" has the same meaning as 40
provided in section 4 of this act; 41
(2) "Emergency medical services" has the same meaning as provided 42
in section 4 of this act; 43
(3) "Gender-affirming health care services" has the same meaning as 44
provided in section 52-571n of the general statutes; 45 Substitute Bill No. 7
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(4) "Health care entity" means an entity that supervises, controls, 46
grants privileges to, directs the practice of or, directly or indirectly, 47
restricts the practice of a health care provider; 48
(5) "Health care provider" means a person who (A) provides health 49
care services, (B) is licensed, certified or registered pursuant to title 20 50
of the general statutes, and (C) is employed by or acting on behalf of a 51
health care entity; 52
(6) "Medically accurate and appropriate information and counseling" 53
means information and counseling that is (A) supported by the weight 54
of current scientific evidence, (B) derived from research using accepted 55
scientific methods, (C) consistent with generally recognized scientific 56
theory, (D) published in peer-reviewed journals, as appropriate, and (E) 57
recognized as accurate, complete, objective and in accordance with the 58
accepted standard of care by professional organizations and agencies 59
with expertise in the relevant field; 60
(7) "Medical hazard" has the same meaning as provided in section 4 61
of this act; and 62
(8) "Reproductive health care services" has the same meaning as 63
provided in section 52-571n of the general statutes. 64
(b) (1) No health care entity shall limit the ability of a health care 65
provider who is acting in good faith, within the health care provider's 66
scope of practice, education, training and experience, including the 67
health care provider's specialty area of practice and board certification, 68
and within the accepted standard of care, from providing the following 69
with regard to reproductive health care services and gender-affirming 70
health care services: 71
(A) Comprehensive, medically accurate and appropriate information 72
and counseling that (i) conforms to the accepted standard of care 73
provided to an individual patient, and (ii) concerns such patient's health 74
status, including, but not limited to, diagnosis, prognosis, 75
recommended treatment, treatment alternatives and potential risks to 76 Substitute Bill No. 7
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the patient's health or life; or 77
(B) Comprehensive, medically accurate and appropriate information 78
and counseling about available and relevant services and resources in 79
the community and methods to access such services and resources to 80
obtain health care of the patient's choosing. 81
(2) Nothing in subdivision (1) of this subsection shall be construed to 82
prohibit a health care entity that employs a health care provider from 83
performing relevant peer review of the health care provider or requiring 84
such health care provider to: 85
(A) Comply with preferred provider network or utilization review 86
requirements of any program or entity authorized by state or federal 87
law to provide insurance coverage for health care services to an enrollee; 88
and 89
(B) Meet established health care quality and patient safety guidelines 90
or rules. 91
(3) No health care entity shall discharge or discipline a health care 92
provider solely for providing information or counseling as described in 93
subdivision (1) of this subsection. 94
(c) (1) If a health care provider is acting in good faith, within the scope 95
of the health care provider's practice, education, training and experience 96
and within the accepted standard of care, a hospital with an emergency 97
department shall not prohibit the health care provider from providing 98
any emergency medical services, including reproductive health care 99
services, (A) if the failure to provide such services would violate the 100
accepted standard of care, or (B) if the patient is suffering from an 101
emergency medical condition. 102
(2) Nothing in subdivision (1) of this subsection shall be construed to 103
prohibit a health care entity from limiting a health care provider's 104
practice for purposes of: 105
(A) Complying with preferred provider network or utilization review 106 Substitute Bill No. 7
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requirements of any program or entity authorized by state or federal 107
law to provide insurance coverage for health care services to an enrollee; 108
or 109
(B) Ensuring quality of care and patient safety, including, but not 110
limited to, when quality of care or patient safety issues are identified 111
pursuant to peer review. 112
(3) A health care entity shall not discharge or discipline a health care 113
provider for providing any emergency medical services, including, but 114
not limited to, reproductive health care services, (A) if the failure to 115
provide such services would violate the accepted standard of care, or 116
(B) if the patient is suffering from an emergency medical condition. 117
(4) A health care entity shall not discharge or discipline a health care 118
provider acting within the scope of such provider's practice, education, 119
training and experience and within the accepted standard of care who 120
refuses to transfer a patient when the health care provider determines, 121
within reasonable medical probability, that the transfer or delay caused 122
by the transfer will create a medical hazard to the patient. 123
Sec. 4. (NEW) (Effective July 1, 2025) As used in this section and 124
sections 5 to 12, inclusive, of this act: 125
(1) "Emergency medical services" means (A) medical screening, 126
examination and evaluation by a physician or any other licensed health 127
care provider acting independently or, as required by applicable law, 128
under the supervision of a physician, to determine if an emergency 129
medical condition or active labor exists and, if so, the care, treatment 130
and surgery that is (i) necessary to relieve or eliminate the emergency 131
medical condition, and (ii) within the scope of the facility's license where 132
the physician or provider is practicing, provided such care, treatment or 133
surgery is within the scope of practice of such physician or provider, 134
and (B) if it is determined that the emergency medical condition that 135
exists is a pregnancy complication, all reproductive health care services 136
related to the pregnancy complication, including, but not limited to, 137
miscarriage management and the treatment of an ectopic pregnancy, 138 Substitute Bill No. 7
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that are (i) necessary to relieve or eliminate the emergency medical 139
condition, and (ii) within the scope of the facility's license where the 140
physician or health care provider is providing such services, provided 141
such services are within the scope of practice of such physician or 142
provider. 143
(2) "Emergency medical condition" means a medical condition 144
manifesting itself by acute or severe symptoms, including, but not 145
limited to, severe pain, where the absence of immediate medical 146
attention could reasonably be expected to result in any of the following: 147
(A) Placement of the patient's life or health in serious jeopardy; 148
(B) Serious impairment to bodily functions; or 149
(C) Serious dysfunction of any bodily organ or part. 150
(3) "Active labor" means a labor at a time at which either of the 151
following is true: 152
(A) There is inadequate time to safely transfer the patient to another 153
hospital prior to delivery; or 154
(B) A transfer may pose a threat to the health and safety of the patient 155
or the fetus. 156
(4) "Hospital" has the same meaning as provided in section 19a-490 157
of the general statutes. 158
(5) "Medical hazard" means a material deterioration in, or jeopardy 159
to, a patient's medical condition or expected chances for recovery. 160
(6) "Qualified personnel" means a physician or other licensed health 161
care provider acting within the scope of such person's licensure who has 162
the necessary licensure, training, education and experience to provide 163
the emergency medical services necessary to stabilize a patient. 164
(7) "Consultation" means the rendering of an opinion or advice, 165
prescribing treatment or the rendering of a decision regarding 166 Substitute Bill No. 7
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hospitalization or transfer by telephone or other means of 167
communication, when determined to be medically necessary, jointly by 168
the (A) treating physician or other qualified personnel acting within the 169
scope of such personnel's licensure either independently or, when 170
required by law, under the supervision of a physician, and (B) 171
consulting physician, including, but not limited to, a review of the 172
patient's medical record and examination and treatment of the patient 173
in person, by telephone or through telehealth by a consulting physician 174
or other qualified personnel acting within the scope of such personnel's 175
licensure either independently or, when required by law, under the 176
supervision of a consulting physician, which physician or qualified 177
personnel is qualified to give an opinion or render the necessary 178
treatment to stabilize the patient. 179
(8) "Stabilized" means the patient's medical condition is such that, 180
within reasonable medical probability in the opinion of the treating 181
physician or any other qualified personnel acting within the scope of 182
such personnel's licensure either independently or, when required by 183
law, under the supervision of a treating physician, no medical hazard is 184
likely to result from, or occur during, the transfer or discharge of the 185
patient as provided in section 6 or 7 of this act or any other relevant 186
provision of the general statutes. 187
Sec. 5. (NEW) (Effective July 1, 2025) (a) Each hospital licensed 188
pursuant to chapter 368v of the general statutes that maintains and 189
operates (1) an emergency department to provide emergency medical 190
services to the public, or (2) a freestanding emergency department, as 191
defined in section 19a-493d of the general statutes, shall provide 192
emergency medical services to any person requesting such services, or 193
for whom such services are requested by an individual with authority 194
to act on behalf of the person, who has a medical condition that places 195
the person in danger of loss of life or serious injury or illness when the 196
hospital has appropriate facilities and qualified personnel available to 197
provide such services. 198
(b) No hospital or hospital employee and no physician or other 199 Substitute Bill No. 7
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licensed health care provider affiliated with a hospital shall be liable 200
under this section in any action arising out of a refusal of the hospital, 201
hospital employee, physician or other licensed health care provider to 202
render emergency medical services to a person if the refusal is based on 203
the hospital's, hospital employee's, physician's or provider's 204
determination, while exercising reasonable care, that (1) such person is 205
not experiencing an emergency medical condition, or (2) the hospital 206
does not have the appropriate facilities or qualified personnel available 207
to render such services to such person. 208
(c) A hospital shall render emergency medical services to a person 209
without first questioning such person or any other individual regarding 210
such person's ability to pay for such services. A hospital may follow 211
reasonable registration processes for persons for whom an examination 212
is required under this section, including, but not limited to, inquiring as 213
to whether the person has health insurance and, if so, details regarding 214
such health insurance, provided such inquiry does not delay an 215
evaluation of such person or the provision of emergency medical 216
services to such person. Such reasonable registration processes may not 217
unduly discourage persons from remaining at the hospital for further 218
evaluation. 219
Sec. 6. (NEW) (Effective July 1, 2025) (a) A hospital shall not transfer 220
any person needing emergency medical services to another hospital for 221
any nonmedical reason, including, but not limited to, the person's 222
inability to pay for any emergency medical services, unless each of the 223
following conditions are met: 224
(1) A physician has examined and evaluated the person prior to 225
transfer, including, if necessary, by engaging in a consultation. A 226
request for consultation shall be made by the treating physician or by 227
other qualified personnel acting within the scope of such personnel's 228
licensure either independently or, when required by law, under the 229
supervision of a treating physician, provided the request by such 230
qualified personnel is made with the contemporaneous approval of the 231
treating physician. 232 Substitute Bill No. 7
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(2) The person has been provided with emergency medical services, 233
including, but not limited to, an abortion, if an abortion was medically 234
necessary to stabilize the patient, and it can be determined by the 235
hospital, within reasonable medical probability, that such person's 236
emergency medical condition has been stabilized and the transfer or 237
delay caused by the transfer will not create a medical hazard to such 238
person. 239
(3) A physician at the transferring hospital has notified the receiving 240
hospital and obtained consent to the transfer of the person from a 241
physician at the receiving hospital and confirmation by the receiving 242
hospital that the person meets the receiving hospital's admissions 243
criteria relating to appropriate bed, personnel and equipment necessary 244
to treat the person. 245
(4) The transferring hospital has provided for appropriate personnel 246
and equipment that a reasonable and prudent physician in the same or 247
similar locality exercising ordinary care would use to affect the transfer. 248
(5) All of the person's pertinent medical records and copies of all of 249
the appropriate diagnostic test results that are reasonably available have 250
been compiled for transfer with the person. Transfer of medical records 251
may be accomplished by a transfer of physical records or by confirming 252
that the receiving hospital has access to the patient's electronic medical 253
records from the transferring hospital. 254
(6) The records transferred with the person shall include a transfer 255
summary signed by the transferring physician that contains relevant 256
transfer information available to the transferring hospital at the time of 257
transfer. The form of the transfer summary shall, at a minimum, contain 258
(A) the person's name, address, sex, race, age, insurance status, 259
presenting symptoms and medical condition, (B) the name and business 260
address of the transferring physician or emergency department 261
personnel authorizing the transfer, (C) the declaration of the signor that 262
the signor is assured, within reasonable medical probability, that the 263
transfer creates no medical hazard to the patient, (D) the time and date 264 Substitute Bill No. 7
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of the transfer, (E) the reason for the transfer, (F) the time and date the 265
person was first presented at the transferring hospital, and (G) the name 266
of the physician at the receiving hospital consenting to the transfer and 267
the time and date of the consent. Neither the transferring physician nor 268
the transferring hospital shall be required to duplicate, in the transfer 269
summary, information contained in medical records transferred with 270
the person. 271
(7) The hospital shall ask the patient if the patient has a preferred 272
contact person to be notified about the transfer and, prior to the transfer, 273
the hospital shall make a reasonable attempt to contact such person and 274
alert them about the proposed transfer. If the patient is not able to 275
respond, the hospital shall make a reasonable effort to ascertain the 276
identity of the preferred contact person or the next of kin and alert such 277
person about the transfer. The hospital shall document in the patient's 278
medical record any attempt to contact a preferred contact person or next 279
of kin. 280
(b) Nothing in this section shall be construed to prohibit the transfer 281
or discharge of a patient when the patient or the patient's authorized 282
representative, including a parent or guardian of the patient, requests a 283
transfer or discharge and gives informed consent to the transfer or 284
discharge against medical advice. 285
(c) The Department of Public Health shall adopt regulations, in 286
accordance with the provisions of chapter 54 of the general statutes, to 287
implement the provisions of this section. 288
Sec. 7. (NEW) (Effective July 1, 2025) (a) A receiving hospital shall 289
accept the transfer of a person from a transferring hospital to the extent 290
required pursuant to section 6 of this act or any contract obligation the 291
receiving hospital has to care for the person. 292
(b) The receiving hospital shall provide personnel and equipment 293
reasonably required by the applicable standard of practice and the 294
regulations adopted pursuant to section 6 of this act to care for the 295
transferred patient. 296 Substitute Bill No. 7
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(c) Any hospital that has suffered a financial loss as a direct result of 297
a hospital's improper transfer of a person or refusal to accept a person 298
for whom the hospital has a legal obligation to provide care may, in a 299
civil action against the participating hospital, obtain damages for such 300
financial loss and such equitable relief as is appropriate. 301
(d) Nothing in this section shall be construed to require a hospital to 302
receive a person from a transferring hospital and make arrangements 303
for the care of a person for whom the hospital does not have a legal 304
obligation to provide care. 305
Sec. 8. (NEW) (Effective July 1, 2025) (a) The Commissioner of Public 306
Health shall require as a condition of licensure of a hospital, pursuant 307
to section 19a-491 of the general statutes, that each hospital adopt, in 308
collaboration with the medical staff of the hospital, policies and transfer 309
protocols consistent with sections 3 to 12, inclusive, of this act and the 310
regulations adopted pursuant to section 6 of this act. 311
(b) The commissioner shall require as a condition of licensure of a 312
hospital, pursuant to section 19a-491 of the general statutes, that each 313
hospital communicate, both orally and in writing, to each person who 314
presents to the hospital's emergency department, or such person's 315
authorized representative, if any such representative is present and the 316
person is unable to understand verbal or written communication, of the 317
reasons for the transfer or refusal to provide emergency medical services 318
and of the person's right to receive such services to stabilize an 319
emergency medical condition prior to transfer to another hospital or 320
health care facility or discharge without regard to ability to pay. 321
Nothing in this subsection shall be construed to require notification of 322
the reasons for the transfer in advance of the transfer when (1) a person 323
is unaccompanied, (2) the hospital has made a reasonable effort to locate 324
an authorized representative of the person, and (3) due to the person's 325
physical or mental condition, notification is not possible. Each hospital 326
shall prominently post a sign in its emergency department informing 327
the public of their rights under sections 3 to 12, inclusive, of this act. 328
Both the written communication and sign required under this 329 Substitute Bill No. 7
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subsection shall include the contact information for the Department of 330
Public Health and identify the department as the state agency to contact 331
if a person wishes to complain about the hospital's conduct. 332
(c) Not later than thirty days after the adoption of regulations 333
pursuant to section 6 of this act, each hospital shall submit its policies 334
and protocols adopted pursuant to subsection (a) of this section to the 335
Department of Public Health. Each hospital shall submit any revisions 336
to such policies or protocols to the department not later than thirty days 337
prior to the effective date of such revisions. 338
Sec. 9. (NEW) (Effective July 1, 2025) (a) Each hospital shall maintain 339
records of each transfer of a person made or received, including the 340
transfer summary described in subdivision (6) of subsection (a) of 341
section 6 of this act, for a period of not less than three years following 342
the date of the transfer. 343
(b) Each hospital making or receiving transfers of persons shall file 344
with the Department of Public Health annual reports, in a form and 345
manner prescribed by the Commissioner of Public Health, that shall 346
describe the aggregate number of transfers made and received, the 347
insurance status of each person transferred and the reasons for such 348
transfers. 349
(c) Each receiving hospital, physician and licensed emergency room 350
health care personnel at the receiving hospital, and each licensed 351
emergency medical services personnel, as defined in section 19a-175 of 352
the general statutes, effectuating the transfer of a person who knows of 353
an apparent violation of any provision of sections 4 to 11, inclusive, of 354
this act or the regulations adopted pursuant to section 6 of this act, shall, 355
and each transferring hospital and each physician and other provider 356
involved in the transfer at such hospital may, report such violation to 357
the Department of Public Health, in a form and manner prescribed by 358
the Commissioner of Public Health, not later than fourteen days after 359
the occurrence of such violation. When two or more persons required to 360
report a violation have joint knowledge of an apparent violation, a 361 Substitute Bill No. 7
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single report may be made by a member of the hospital personnel 362
selected by mutual agreement in accordance with hospital protocols. 363
Any person required to report a violation who disagrees with a 364
proposed joint report shall report individually. 365
(d) No hospital, state agency or person shall retaliate against, 366
penalize, institute a civil action against or recover monetary relief from, 367
or otherwise cause any injury to, any physician, other hospital personnel 368
or emergency medical services personnel for reporting in good faith an 369
apparent violation of any provision of sections 4 to 11, inclusive, of this 370
act or the regulations adopted pursuant to section 6 of this act to the 371
Department of Public Health, the hospital, a member of the hospital's 372
medical staff or any other interested party or government agency. 373
Sec. 10. (NEW) (Effective July 1, 2025) (a) Except as otherwise provided 374
in sections 4 to 11, inclusive, of this act, the Commissioner of Public 375
Health shall investigate each alleged violation of said sections and the 376
regulations adopted pursuant to section 6 of this act unless the 377
commissioner concludes that the allegation does not include facts 378
requiring further investigation or is otherwise unmeritorious. 379
(b) The Commissioner of Public Health may take any action 380
authorized by sections 19a-494 and 19a-494a of the general statutes 381
against a hospital or authorized by section 19a-17 of the general statutes 382
against a licensed health care provider for a violation of any provision 383
of sections 4 to 11, inclusive, of this act. 384
Sec. 11. (NEW) (Effective July 1, 2025) (a) A hospital shall not base the 385
provision of emergency medical services to a person, in whole or in part, 386
upon, or discriminate against a person based upon, the person's 387
ethnicity, citizenship, age, preexisting medical condition, insurance 388
status, economic status, ability to pay for medical services, sex, race, 389
color, religion, disability, genetic information, marital status, sexual 390
orientation, gender identity or expression, primary language or 391
immigration status, except to the extent that a circumstance such as age, 392
sex, pregnancy, medical condition related to childbirth, preexisting 393 Substitute Bill No. 7
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medical condition or physical or mental disability is medically 394
significant to the provision of appropriate medical care to the patient. 395
Each hospital shall adopt a policy to implement the provisions of this 396
section. 397
(b) Unless otherwise permitted by contract, each hospital shall 398
prohibit each physician who serves on an on-call basis in the hospital's 399
emergency department from refusing to respond to a call on the basis of 400
the person's ethnicity, citizenship, age, preexisting medical condition, 401
insurance status, economic status, ability to pay for medical services, 402
sex, race, color, religion, disability, current medical condition, genetic 403
information, marital status, sexual orientation, primary language or 404
immigration status, except to the extent that a circumstance such as age, 405
sex, preexisting medical condition or physical or mental disability is 406
medically significant to the provision of appropriate medical care to the 407
patient. If a contract that was in existence on or before July 1, 2025, 408
between a physician and hospital for the provision of emergency 409
department coverage prevents a hospital from imposing the prohibition 410
required under this subsection, the contract shall be revised to include 411
such prohibition as soon as it is legally permissible to make such a 412
revision. Nothing in this section shall be construed to require any 413
physician to serve on an on-call basis for a hospital. 414
Sec. 12. (NEW) (Effective July 1, 2025) (a) Any individual harmed by a 415
violation of any provision of sections 3 to 11, inclusive, of this act may 416
bring, not later than one hundred eighty days after the occurrence of 417
such violation, a civil action against a hospital or other health care entity 418
for such violation. 419
(b) Any hospital or other health care entity found to have violated 420
any provision of sections 3 to 11, inclusive, of this act shall be liable for 421
compensatory damages, with costs and such reasonable attorney's fees 422
as may be allowed by the court. In the case of a health care provider who 423
has been subjected to retaliation or other disciplinary action in violation 424
of any provision of sections 3 to 11, inclusive, of this act, the hospital or 425
other health care entity shall also be liable for the full amount of gross 426 Substitute Bill No. 7
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loss of wages in addition to any compensatory damages for which the 427
hospital or health care entity is liable under this subsection. 428
(c) The court may also provide injunctive relief to prevent further 429
violations of any provision of sections 3 to 11, inclusive, of this act. 430
(d) If the court determines that an action for damages was brought 431
under this section without substantial justification, the court may award 432
costs and reasonable attorney's fees to the hospital or other health care 433
entity. 434
(e) Nothing in this section shall preclude any other causes of action 435
authorized by law or prevent the state or any professional licensing 436
board from taking any action authorized by the general statutes against 437
the hospital, health care entity or an individual health care provider. 438
Sec. 13. (NEW) (Effective July 1, 2025) (a) As used in this section: 439
(1) "Collateral costs" means any out-of-pocket costs, other than the 440
cost of the procedure itself, necessary to receive reproductive health care 441
services or gender-affirming health care services in the state, including, 442
but not limited to, costs for travel, lodging and meals; 443
(2) "Gender-affirming health care services" has the same meaning as 444
provided in section 52-571n of the general statutes; 445
(3) "Health care provider" means any person licensed under the 446
provisions of federal or state law to provide health care services; 447
(4) "Nonprofit organization" means an organization that is exempt 448
from taxation pursuant to Section 501(c)(3) of the Internal Revenue Code 449
of 1986, or any subsequent corresponding internal revenue code of the 450
United States, as amended from time to time; 451
(5) "Patient-identifiable data" means any information that identifies, 452
or may reasonably be used as a basis to identify, an individual patient; 453
(6) "Qualified person" means a person who is a resident of a state that 454 Substitute Bill No. 7
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has enacted laws that limit such person's access to reproductive health 455
care services or gender-affirming health care services; and 456
(7) "Reproductive health care services" means all medical, surgical, 457
counseling or referral services relating to the human reproductive 458
system, including, but not limited to, services relating to fertility, 459
pregnancy, contraception and abortion. 460
(b) There is established an account to be known as the "safe harbor 461
account", which shall be a separate, nonlapsing account of the State 462
Treasurer. The account shall contain any funds received from any 463
private contributions, gifts, grants, donations, bequests or devises to the 464
account. Moneys in the account shall be expended by the board of 465
trustees, established pursuant to subsection (c) of this section, for the 466
purposes of providing grants to (1) health care providers who provide 467
reproductive health care services or gender-affirming health care 468
services, (2) nonprofit organizations whose mission includes providing 469
funding for reproductive health care services or the collateral costs 470
incurred by qualified persons to receive such services in the state, or (3) 471
nonprofit organizations that serve LGBTQ+ youth or families in the 472
state for the purpose of reimbursing or paying for collateral costs 473
incurred by qualified persons to receive reproductive health care 474
services or gender-affirming health care services. 475
(c) The safe harbor account shall be administered by a board of 476
trustees consisting of the following members: 477
(1) The Treasurer, or the Treasurer's designee, who shall serve as 478
chairperson of the board of trustees; 479
(2) The Commissioner of Mental Health and Addiction Services, or 480
the commissioner's designee; 481
(3) The Commissioner of Social Services, or the commissioner's 482
designee; 483
(4) The Commissioner of Public Health, or the commissioner's 484 Substitute Bill No. 7
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designee; and 485
(5) Five members appointed by the Treasurer, (A) one of whom shall 486
be a provider of reproductive health care services in the state, (B) one of 487
whom shall have experience working with members of the LGBTQ+ 488
community, and (C) one of whom shall have experience working with 489
providers of reproductive health care services. When making such 490
appointments, the Treasurer shall use the Treasurer's best efforts to 491
ensure that the board of trustees reflects the racial, gender and 492
geographic diversity of the state. 493
(d) Not later than September 1, 2025, the board of trustees shall adopt 494
policies and procedures concerning the awarding of grants pursuant to 495
the provisions of this section. Such policies and procedures shall 496
include, but need not be limited to, (1) grant application procedures, (2) 497
eligibility criteria for applicants, (3) eligibility criteria for collateral costs, 498
(4) consideration of need, including, but not limited to, financial need, 499
of the applicant, and (5) procedures to coordinate with any national 500
network created to perform similar functions to those of the safe harbor 501
account, including, but not limited to, procedures for the acceptance of 502
funding transferred to the safe harbor account for a particular use. Such 503
policies and procedures shall not require the collection or retention of 504
patient-identifiable data in order to receive a grant. Such policies and 505
procedures may be updated as deemed necessary by the board of 506
trustees. In the event that the board of trustees determines that the 507
policies and procedures adopted pursuant to the provisions of this 508
subsection are inadequate with respect to (A) determining the eligibility 509
of a certain health care provider or nonprofit organization for a grant, 510
or (B) whether a certain health care service received by a qualified 511
person or collateral cost incurred by a qualified person is eligible to be 512
reimbursed or paid by a health care provider or nonprofit organization 513
using grant moneys received pursuant to this section, the board of 514
trustees may make a fact-based determination as to such eligibility. 515
Sec. 14. (NEW) (Effective from passage) It is hereby declared that opioid 516
use disorder constitutes a public health crisis in this state and will 517 Substitute Bill No. 7
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continue to constitute a public health crisis until each goal reported by 518
the Connecticut Alcohol and Drug Policy Council pursuant to 519
subsection (f) of section 17a-667a of the general statutes, as amended by 520
this act, is attained. 521
Sec. 15. Section 17a-667a of the general statutes is amended by adding 522
subsection (f) as follows (Effective from passage): 523
(NEW) (f) The Connecticut Alcohol and Drug Policy Council shall 524
convene a working group to establish one or more goals for the state to 525
achieve in its efforts to combat the prevalence of opioid use disorder in 526
the state. Not later than January 1, 2026, the council shall report, in 527
accordance with the provisions of section 11-4a, to the joint standing 528
committee of the General Assembly having cognizance of matters 529
relating to public health regarding each goal established by the working 530
group. 531
Sec. 16. (Effective from passage) (a) As used in this section: 532
(1) "Priority school district" has the same meaning as described in 533
section 10-266p of the general statutes; and 534
(2) "Geofence" means any technology that uses global positioning 535
coordinates, cell tower connectivity, cellular data, radio frequency 536
identification, wireless fidelity technology data or any other form of 537
location detection, or any combination of such coordinates, connectivity, 538
data, identification or other form of location detection, to establish a 539
virtual boundary. 540
(b) Not later than January 1, 2026, the Department of Education, in 541
consultation with the Department of Children and Families, shall 542
establish a mental and behavioral health awareness and treatment pilot 543
program in priority school districts. The program shall enable not less 544
than one hundred thousand students in such districts to utilize an 545
electronic mental and behavioral health awareness and treatment tool 546
through an Internet web site, online service or mobile application, which 547
tool shall be selected by the Commissioner of Education and provide 548 Substitute Bill No. 7
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each of the following: 549
(1) Mental and behavioral health education resources to promote 550
awareness and understanding of mental and behavioral health issues; 551
(2) Peer-to-peer support services, including, but not limited to, a 552
moderated online peer chat room, where comments submitted by 553
students for posting in the chat room are prescreened and filtered 554
through by a moderator prior to posting, to encourage social connection 555
and mutual support among students; and 556
(3) Private online sessions with mental or behavioral health care 557
providers licensed in the state who (A) have demonstrated experience 558
delivering mental or behavioral health care services to school districts 559
serving both rural and urban student populations, and (B) shall be 560
selected or approved by the Commissioner of Education, provided such 561
sessions comply with the provisions of section 19a-906 of the general 562
statutes concerning telehealth and the provisions of section 19a-14c of 563
the general statutes concerning the provision of outpatient mental 564
health treatment to minors. 565
(c) (1) During its first year of operation, the pilot program shall have 566
the following objectives: (A) To build partnerships between priority 567
school districts and community organizations providing mental and 568
behavioral health care services; and (B) to launch a digital marketing 569
campaign using tools, including, but not limited to, a geofence, to raise 570
awareness and engagement among students concerning mental and 571
behavioral health issues affecting students. 572
(2) Not later than January 1, 2026, the Commissioner of Education 573
shall report, in accordance with the provisions of section 11-4a of the 574
general statutes, regarding the program's success in achieving such 575
objectives to the joint standing committees of the General Assembly 576
having cognizance of matters relating to public health and education. 577
(d) (1) During its second year of operation, the pilot program shall 578
have the following objectives: (A) To refer students to mental and 579 Substitute Bill No. 7
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behavioral health care providers, as needed; and (B) to enhance 580
students' engagement with mental and behavioral health tools, 581
including, but not limited to, coping strategies and clinician support. 582
(2) Not later than January 1, 2027, the Commissioner of Education 583
shall report, in accordance with the provisions of section 11-4a of the 584
general statutes, regarding the program's success in achieving such 585
objectives to the joint standing committees of the General Assembly 586
having cognizance of matters relating to public health and education. 587
Sec. 17. (Effective from passage) The sum of three million six hundred 588
thousand dollars is appropriated to the Department of Education from 589
the General Fund, for the fiscal year ending June 30, 2026, for the 590
administration of the mental and behavioral health awareness and 591
treatment pilot program established pursuant to section 16 of this act. 592
Sec. 18. (NEW) (Effective from passage) There is established an account 593
to be known as the "public health urgent communication account", 594
which shall be a separate, nonlapsing account. The account shall contain 595
any moneys required by law to be deposited in the account. Moneys in 596
the account shall be expended by the Department of Public Health for 597
the purposes of providing timely, effective communication to members 598
of the general public, health care providers and other relevant 599
stakeholders during a public health emergency, as described in section 600
19a-131a of the general statutes. 601
Sec. 19. (Effective from passage) The sum of five million dollars is 602
appropriated to the Department of Public Health from the General 603
Fund, for the fiscal year ending June 30, 2026, for deposit into the "public 604
health urgent communication account" established pursuant to section 605
18 of this act. 606
Sec. 20. (NEW) (Effective from passage) There is established an account 607
to be known as the "emergency public health financial safeguard 608
account", which shall be a separate, nonlapsing account. The account 609
shall contain any moneys required by law to be deposited in the account. 610
Moneys in the account shall be expended by the Department of Public 611 Substitute Bill No. 7
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Health for the purposes of addressing unexpected shortfalls in public 612
health funding and ensuring the Department of Public Health's ability 613
to respond to the health care needs of state residents and provide a 614
continuity of essential public health services. 615
Sec. 21. (Effective from passage) The sum of thirty million dollars is 616
appropriated to the Department of Public Health from the General 617
Fund, for the fiscal year ending June 30, 2026, for deposit into the 618
"emergency public health financial safeguard account" established 619
pursuant to section 20 of this act. 620
Sec. 22. (NEW) (Effective October 1, 2025) As used in this section and 621
sections 23 to 25, inclusive, of this act: 622
(1) "Commissioner" means the Commissioner of Public Health; 623
(2) "Department" means the Department of Public Health; 624
(3) "Health care administrator" means a person employed by a 625
hospital who is a: 626
(A) Nonclinical hospital manager with direct supervisory authority 627
over clinical health care providers who is responsible for one or more of 628
the following activities: 629
(i) Hiring, scheduling, evaluating and providing direct supervision 630
of clinical health care providers; 631
(ii) Monitoring hospital activities for compliance with state or federal 632
regulatory requirements; or 633
(iii) Developing fiscal reports for clinical units of the hospital or the 634
hospital as a whole; or 635
(B) Nonclinical hospital director, officer or executive who has direct 636
or indirect supervisory authority over only nonclinical hospital 637
managers described in subparagraph (A) of this subdivision, for one or 638
more of the following activities: 639 Substitute Bill No. 7
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(i) Hiring and supervising such nonclinical hospital managers; 640
(ii) Providing oversight of operations for the hospital or any of its 641
departments; 642
(iii) Developing policies and procedures establishing the standards of 643
patient care; 644
(iv) Providing oversight of budgetary and financial decisions related 645
to operations and the delivery of patient care for the hospital or any of 646
its departments; and 647
(v) Ensuring that hospital policies comply with state and federal 648
regulatory requirements; and 649
(4) "Hospital" means an institution licensed as a hospital pursuant to 650
chapter 368v of the general statutes. 651
Sec. 23. (NEW) (Effective October 1, 2025) (a) No person shall practice 652
as a health care administrator unless such person is licensed pursuant 653
to section 24 of this act. 654
(b) No person may use the title "health care administrator" or make 655
use of any title, words, letters or abbreviations indicating or implying 656
that such person is licensed to practice as a health care administrator 657
pursuant to section 24 of this act. 658
Sec. 24. (NEW) (Effective October 1, 2025) (a) Except as provided in 659
subsection (b) of this section, the commissioner shall grant a license to 660
practice as a health care administrator to an applicant who presents 661
evidence satisfactory to the commissioner that such applicant has: (1) A 662
baccalaureate or graduate degree in health care administration, public 663
health or a related field from a regionally accredited institution of higher 664
education, or from an institution of higher education outside of the 665
United States that is legally chartered to grant postsecondary degrees in 666
the country in which such institution is located; (2) passed an 667
examination prescribed by the department designed to test the 668
applicant's knowledge of health care laws, patient safety protocols and 669 Substitute Bill No. 7
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health-related ethical guidelines; and (3) submitted a completed 670
application in a form and manner prescribed by the department. The fee 671
for an initial license under this section shall be two hundred dollars. 672
(b) The department may grant licensure without examination, subject 673
to payment of fees with respect to the initial application, to any 674
applicant who is currently licensed or certified as a health care 675
administrator in another state, territory or commonwealth of the United 676
States, provided such state, territory or commonwealth maintains 677
licensure or certification standards that, in the opinion of the 678
department, are equivalent to or higher than the standards of this state. 679
No license shall be issued under this section to any applicant against 680
whom professional disciplinary action is pending or who is the subject 681
of an unresolved complaint. 682
(c) A license issued to a health care administrator under this section 683
may be renewed annually in accordance with the provisions of section 684
19a-88 of the general statutes, as amended by this act. The fee for such 685
renewal shall be one hundred five dollars. Each licensed health care 686
administrator applying for license renewal shall furnish evidence 687
satisfactory to the commissioner of having participated in continuing 688
education programs prescribed by the department. The commissioner 689
shall adopt regulations, in accordance with chapter 54 of the general 690
statutes, to (1) define basic requirements for continuing education 691
programs, (2) delineate qualifying programs, (3) establish a system of 692
control and reporting, and (4) provide for waiver of the continuing 693
education requirement for good cause. 694
Sec. 25. (NEW) (Effective October 1, 2025) (a) The department shall 695
have jurisdiction to hear all charges of unacceptable conduct brought 696
against a person licensed as a health care administrator. The 697
commissioner shall provide written notice of such hearing to such 698
person not later than thirty days prior to such hearing. After holding 699
such hearing, the department may take any of the actions set forth in 700
section 19a-17 of the general statutes, if it finds that any grounds for 701
action by the department enumerated in subsection (b) of this section 702 Substitute Bill No. 7
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exist. Any person aggrieved by the finding of the department may 703
appeal such finding in accordance with the provisions of section 4-183 704
of the general statutes, and such appeal shall have precedence over 705
nonprivileged cases in respect to order of trial. 706
(b) The department may take action under section 19a-17 of the 707
general statutes for any of the following reasons: (1) A fiscal or 708
operational decision that results in injury to a patient or creates an 709
unreasonable risk that a patient may be harmed; (2) a violation by a 710
licensed health care provider of a state or federal statute or 711
administrative rule regulating a profession when the health care 712
administrator was responsible for the oversight of the licensed health 713
care provider; (3) aiding or abetting a licensed health care provider to 714
practice the provider's health care profession after a patient complaint 715
or adverse event has been reported to the hospital employing the 716
licensed health care administrator, the department or the appropriate 717
disciplining authority, while the complaint or adverse event is being 718
investigated, and if harm, disability or death of a patient occurred after 719
the complaint or report of the adverse event; (4) failure to adequately 720
supervise licensed clinical staff and nonclinical staff to the extent that a 721
patient's health or safety is at risk; (5) any administrative, operational or 722
fiscal decision that impedes a clinical licensed health care provider from 723
adhering to standards of practice or leads to patient harm, disability or 724
death; or (6) a fiscal or operational decision resulting in the inability of 725
licensed clinical health care providers to practice with reasonable skill 726
and safety, regardless of the occurrence of patient harm, disability or 727
death. The commissioner may order a license holder to submit to a 728
reasonable physical or mental examination if such license holder's 729
physical or mental capacity to practice safely is being investigated. The 730
commissioner may petition the superior court for the judicial district of 731
Hartford to enforce such order or any action taken pursuant to section 732
19a-17 of the general statutes. 733
Sec. 26. Subdivision (1) of subsection (e) of section 19a-88 of the 734
general statutes is repealed and the following is substituted in lieu 735
thereof (Effective October 1, 2025): 736 Substitute Bill No. 7
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(e) (1) Each person holding a license or certificate issued under 737
section 24 of this act, section 19a-514, 20-65k, 20-74s, 20-185k, 20-185l, 20-738
195cc or 20-206ll and chapters 370 to 373, inclusive, 375, 378 to 381a, 739
inclusive, 383 to 383c, inclusive, 383g, 384, 384a, 384b, 385, 393a, 395, 399 740
or 400a and section 20-206n or 20-206o shall, annually, or, in the case of 741
a person holding a license as a marital and family therapist associate 742
under section 20-195c on or before twenty-four months after the date of 743
initial licensure, during the month of such person's birth, apply for 744
renewal of such license or certificate to the Department of Public Health, 745
giving such person's name in full, such person's residence and business 746
address and such other information as the department requests. 747
Sec. 27. (NEW) (Effective July 1, 2025) (a) As used in this section: 748
(1) "Advanced practice registered nurse" means an individual 749
licensed as an advanced practice registered nurse pursuant to chapter 750
378 of the general statutes; 751
(2) "Physician" means an individual licensed as a physician pursuant 752
to chapter 370 of the general statutes; 753
(3) "Physician assistant" means an individual licensed as a physician 754
assistant pursuant to chapter 370 of the general statutes; and 755
(4) "Sudden unexpected death in epilepsy" means the death of a 756
person with epilepsy that is not caused by injury, drowning or other 757
known causes unrelated to epilepsy. 758
(b) On and after October 1, 2025, each physician, advanced practice 759
registered nurse and physician assistant who regularly treats patients 760
with epilepsy shall provide each such patient with information 761
concerning the risk of sudden unexpected death in epilepsy and 762
methods to mitigate such risk. 763
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 19a-38 Substitute Bill No. 7
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Sec. 2 from passage New section
Sec. 3 July 1, 2025 New section
Sec. 4 July 1, 2025 New section
Sec. 5 July 1, 2025 New section
Sec. 6 July 1, 2025 New section
Sec. 7 July 1, 2025 New section
Sec. 8 July 1, 2025 New section
Sec. 9 July 1, 2025 New section
Sec. 10 July 1, 2025 New section
Sec. 11 July 1, 2025 New section
Sec. 12 July 1, 2025 New section
Sec. 13 July 1, 2025 New section
Sec. 14 from passage New section
Sec. 15 from passage 17a-667a(f)
Sec. 16 from passage New section
Sec. 17 from passage New section
Sec. 18 from passage New section
Sec. 19 from passage New section
Sec. 20 from passage New section
Sec. 21 from passage New section
Sec. 22 October 1, 2025 New section
Sec. 23 October 1, 2025 New section
Sec. 24 October 1, 2025 New section
Sec. 25 October 1, 2025 New section
Sec. 26 October 1, 2025 19a-88(e)(1)
Sec. 27 July 1, 2025 New section
Statement of Legislative Commissioners:
In Sec. 13(a)(1), "or gender-affirming health care services" was inserted
after "reproductive health care services" for consistency with the
provisions of subsection (b) of said section.
PH Joint Favorable Subst.