HB 5514 — AN ACT CONCERNING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES.

742 (B) Determine nitrogen credit equal to the nitrogen credit values for nitrogen removal technologies approved by the Department of Energy andEnvironmentalProtectionthathavenotbeenpublishedpriortoJuly 1, 2028, in the technical standards established pursuant to subdivision (1) of this subsection, for nitrogen removal technologies that meet the definition of subsurface sewage disposal systems as established in regulation pursuant to subdivision (1) of this subsection;

(a) (1) Notwithstanding the provisions of section 20-198, the Department of Public HealthAct mayNo. issue a license by endorsement to any veterinarian of good professional character who is currently licensed and practicing in some other state or territory, having requirements for admission determined by the department to be at least equal to the requirements of this state, upon the payment of a fee of five hundred sixty-five dollarsto said department.

Notwithstanding26-13 the9 provisions of section73 20-198,Substitute theHouse departmentBill may, upon payment of a fee of five hundred sixty-five dollars, issue a license without examination to a currently practicing, competent veterinarian in another state or territory who [(1)] (A) holds a current valid license in good professional standing issued after examination by another state or territory that maintains licensing standards which, except for examination, are commensurate with this state's standards, and [(2)] (B) has worked continuously as a sHB5514 / File No.

7425514 sHB5514(a) File(1) No.Notwithstanding the provisions of section 20-198, the Department of Public Health may issue a license by endorsement to any veterinarian of good professional character who is currently licensed and practicing in some other state or territory, having requirements for admission determined by the department to be at least equal to the requirements of this state, upon the payment of a fee of five hundred sixty-five dollarsto said department.

742Notwithstanding the provisions of section 20-198, the department may, upon payment of a fee of five hundred sixty-five dollars, issue a license without examination to a currently practicing, competent veterinarian in another state or territory who [(1)] (A) holds a current valid license in good professional standing issued after examination by another state or territory that maintains licensing standards which, except for examination, are commensurate with this state's standards, and [(2)] (B) has worked continuously as a licensed veterinarian in an academic or clinical setting in another state or territory for a period of not less than five years immediately preceding the application for licensure without examination.

The department shall not issue a temporary permit under this section to any applicant against whomPublic professionalAct disciplinaryNo. action is pending, or who is the subject of an unresolved complaint.

(b)Notwithstanding26-13 the10 provisionsofsection 20-198,theDepartment of Public73 HealthSubstitute mayHouse issueBill aNo. temporary permit to an applicant who (1) is a graduate from a school located outside of the United States, its territories or Canada with a degree of doctor of veterinary medicine, or its equivalent, from a program acceptable to the American Veterinary Medical Association as required to receive certification by the Educational Commission for Foreign Veterinary Graduates, and (2) is working toward receiving certificationfrom the Educational Commission for Foreign Veterinary Graduates or Program for the Assessment of Veterinary Education Equivalence.

5514 whom professional disciplinary action is pending, or who is the subject of an unresolved complaint.

(b)Notwithstanding the provisionsofsection 20-198,theDepartment of Public Health may issue a temporary permit to an applicant who (1) is a graduate from a school located outside of the United States, its territories or Canada with a degree of doctor of veterinary medicine, or its equivalent, from a program acceptable to the American Veterinary Medical Association as required to receive certification by the Educational Commission for Foreign Veterinary Graduates, and (2) is working toward receiving certification from the Educational Commission for Foreign Veterinary Graduates or Program for the Assessment of Veterinary Education Equivalence.

Such temporary permit shall be valid for a period not to exceed two years after the date of sHB5514issuance, /except Filesuch No.temporary permit shall be renewable once for a period of two years if the applicant fails to receive certification from the Educational Commission for Foreign Veterinary Graduates or Program for the Assessment of Veterinary Education Equivalence within the first two-year period.

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742 issuance, except such temporary permit shall be renewable once for a period of two years if the applicant fails to receive certification from the Educational Commission for Foreign Veterinary Graduates or Program for the Assessment of Veterinary Education Equivalence within the first two-year period.

The working group shall (1) evaluate the feasibility of permitting the establishment of a veterinarian-client- patient relationship through veterinary telemedicine in the state when an animal is in need of medical care or treatment, and (2) if the working groupPublic determinesAct thatNo. permitting such establishment is feasible, make recommendations regarding the parameters of such relationship.

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5514 group determines that permitting such establishment is feasible, make recommendations regarding the parameters of such relationship.

(3) One appointed by the House chairperson of the joint standing committee of the General Assembly having cognizance of matters relating to public health, who shall be a proponent of the establishment of a veterinarian-client-patientrelationshipveterinarian-client-patient relationship through veterinary telemedicine when an animal is in need of medical care or treatment;

sHB5514(4)OneappointedbytheSenaterankingmemberofthejointstanding /committee Fileof No.the General Assembly having cognizance of matters relating to public health, who shall be a proponent of the establishment of a veterinarian-client-patient relationship through veterinary telemedicine when an animal is in need of medical care or treatment;

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742 (4)OneappointedbytheSenaterankingmemberofthejointstanding committee of the General Assembly having cognizance of matters relating to public health, who shall be a proponent of the establishment of a veterinarian-client-patientrelationship through veterinary telemedicine when an animal is in need of medical care or treatment;

(c) The administrative staff of the joint standing committee of the General Assembly having cognizance of matters relating to public healthPublic shallAct serveNo. as administrative staff of the working group.

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5514 health shall serve as administrative staff of the working group.

sHB5514(2) /"Buprenorphine" Filemeans No.a synthetic opiate with partial agonist actions approved by the federal Food and Drug Administration or any successor agency for the treatment of opioid use disorder;

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742 (2) "Buprenorphine" means a synthetic opiate with partial agonist actions approved by the federal Food and Drug Administration or any successor agency for the treatment of opioid use disorder;

(5)Public "Methadone"Act meansNo. a long-acting synthetic opioid agonist approved by the federal Food and Drug Administration or any successor agency for the treatment of opioid use disorder;

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5514 (5) "Methadone" means a long-acting synthetic opioid agonist approved by the federal Food and Drug Administration or any successor agency for the treatment of opioid use disorder;

(b) On and after January 1, 2027, each hospital licensed pursuant to chapter 368v of the general statutes (1) may, to the extent permitted under federal law, (A) administer buprenorphine or methadone to each patient presenting to the hospital's emergency department with symptomsofopioid use disorderwithout requiring theadmissionofthe patient to the hospital for the sole purpose of such administration, provided (i) the administration of buprenorphine or methadone is sHB5514clinically /indicated, Fileand (ii) the patient consents to such administration, (B)offerthepatientaprescriptionfororasupplyofanopioidantagonist at the time of such patient's discharge from the emergency department and, if the patient accepts the offer, provide the patient with such prescription or dispense an opioid antagonist to the patient, and (C) refer the patient to one or more community providers or opioid treatment programs that can provide continuity in the prescription of buprenorphine or administration of methadone, as applicable, and (2) may, if clinically indicated, dispense a supply of methadone to each Public Act No.

74226-13 sHB551414 Fileof 73 Substitute House Bill No.

7425514 clinically indicated, and (ii) the patient consents to such administration, (B)offerthepatientaprescriptionfororasupplyofanopioidantagonist at the time of such patient's discharge from the emergency department and, if the patient accepts the offer, provide the patient with such prescription or dispense an opioid antagonist to the patient, and (C) refer the patient to one or more community providers or opioid treatment programs that can provide continuity in the prescription of buprenorphine or administration of methadone, as applicable, and (2) may, if clinically indicated, dispense a supply of methadone to each such patient in accordance with the provisions of section 21 CFR 1306.

(1) The prevalence and impact of endometriosis on residents of the sHB5514state; / File No.

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742 state;

(4) Insurance coverage and reimbursement practices for the treatmentPublic ofAct endometriosis;No.

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5514 treatment of endometriosis;

(2) Four appointed by the president pro tempore of the Senate, (A) one of whom shall be a member of the Senate, (B) one of whom shall be a physician licensed pursuant to chapter 370 of the general statutes who is a member of the American College of Obstetricians and Gynecologists, (C) one of whom shall be a researcher affiliated with an academic or research institution in the state with expertise in sHB5514endometriosis, /and File(D) No.one of whom shall be a patient advocate with experience advocating on behalf of individuals with endometriosis;

742(3) sHB5514Four Fileappointed by the minority leader of the House of Representatives, (A) one of whom shall be a member of the House of Public Act No.

74226-13 endometriosis,16 and (D) one of whom73 shallSubstitute beHouse aBill patientNo. advocate with experience advocating on behalf of individuals with endometriosis;

(3)5514 Four appointed by the minority leader of the House of Representatives, (A) one of whom shall be a member of the House of Representatives, (B) one of whom shall be a pediatric or an adolescent medicine physician licensed pursuant to chapter 370 of the general statutes and currently practicing in the state, (C) one of whom shall be an individual in the state with expertise in racial and health equity or who represents a community-based organization serving historically underservedpopulations,and(D)oneofwhomshallbearepresentative ofanassociationofhospitalsinthestateoranadministratorofahospital in the state;

The executive director of the Commission on Women, sHB5514Children, /Seniors, FileEquity and Opportunity shall determine which of the members first appointed shall serve for a term of two years and which Public Act No.

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7425514 Children, Seniors, Equity and Opportunity shall determine which of the members first appointed shall serve for a term of two years and which of such members shall serve for a term of three years.

The council shall advise and make recommendations to the Department of Public Health and other state agencies, as appropriate, regarding (1) the availability of chimeric antigen receptor T-cell therapy and other gene therapies in the state for the treatment of cancer, (2) safe, equitable and financially sustainable delivery of such therapies, (3) advanced training for clinical providers of such therapies, sHB5514Public /Act File No.

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7425514 (4) long-term follow-up and vector safety for patients receiving such therapies, (5)thedevelopment ofreferralandmanagement protocolsfor such therapies, (6) education for clinicians, patients and patients' relativesandcaregiversregardingsuchtherapiesandsuchprotocols,(7) advising patients and their relatives and caregivers regarding the cost and availability of insurance coverage for such therapies, (8) opportunities for coordinating with research collaborations, government agencies, including, but not limited to, the Centers for Medicare and Medicaid Services, accrediting bodies and national registries regarding such therapies, (9) the development of centers of excellence in the state for the delivery of such therapies, including, but not limited to, requiring accreditation of such centers, (10) the development of a state-wide referral network to ensure all eligible patients are matched with a center of excellence in the state, (11) the development of safety protocols to address complications experienced by patients receiving such therapies and other safety concerns, (12) methods of providing psychosocial support to patients receiving such therapies and their relatives and caregivers, and (13) methods of tracking patient outcomes with a focus on equity as it relates to diagnosis, race, ethnicity, geography and income.

and (3)ResearchandPublic makeAct recommendationstoNo. the Department ofPublic Health and other state agencies.

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7425514 sHB5514(3)Researchand Filemake No.recommendationsto the Department ofPublic Health and other state agencies.

742 (c) The council shall consist of the following members:

(7) Four appointed by the Senate ranking member of the joint standingPublic committeeAct of the General Assembly having cognizance of matters relating to public health, one of whom shall be a representative of an internationally recognized accreditation body for institutions providing cellular therapies, one of whom shall be a representative of an association of health carriers in the state, one of whom shall be the sHB5514 / File No.

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7425514 standing committee of the General Assembly having cognizance of matters relating to public health, one of whom shall be a representative of an internationally recognized accreditation body for institutions providing cellular therapies, one of whom shall be a representative of an association of health carriers in the state, one of whom shall be the directorofa cellular therapy programinthestate andoneofwhomshall be a representative of the life sciences or biotechnology industry;

(f)Public NotAct later than one year after the date of its first meeting, and annually thereafter, the council shall report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and insurance regarding its findings and recommendations, including, but not limited to, (1) the council's sHB5514 / File No.

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7425514 (f) Not later than one year after the date of its first meeting, and annually thereafter, the council shall report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health and insurance regarding its findings and recommendations, including, but not limited to, (1) the council's activities, research findings and any recommendations for proposed legislative changes, and (2) any potential sources of funding for the council's activities, including, but not limited to, grants, donations, sponsorships or in-kind donations.

Section 10-206 of the general statutes, as amended by section 39 of public act 26-1, is repealed and the following is substituted in lieu thereof (Effective July 1, 2026):

Such assessments shall be conducted by (1) a legally qualified practitioner of medicine, (2) an advanced practice registered nurse or registered nurse, licensed pursuant to chapter 378, (3) a physician assistant, licensed pursuant to chapter 370, (4) a school medical advisor, or (5) a legally qualified practitioner of medicine, an advanced practice registered nurse or a physician assistant stationed at any military base, to ascertain whether such pupil is suffering from any physical disability tending to prevent such pupil from receiving the full benefitPublic ofAct schoolNo. work and to ascertain whether such school work should be modified in order to prevent injury to the pupil or to secure for the pupil a suitable program of education.

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5514 benefit of school work and to ascertain whether such school work should be modified in order to prevent injury to the pupil or to secure for the pupil a suitable program of education.

The parent or guardian of such pupil shall receive prior written notice and shall have a reasonable opportunity to be present at such assessment or to provide for such sHB5514assessment /himself Fileor No.herself.

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742 assessment himself or herself.

The assessment shall also include tests for tuberculosis, sickle cell anemia and Cooley's anemia wherePublic theAct localNo. or regional board of education determines after consultation with the school medical advisor and the local health department, or in the case of a regional board of education, each local health department, that such tests are necessary, provided a registered nurse may only perform said tests pursuant to the written order of a physician or physician assistant, licensed pursuant to chapter 370, or an advanced practice registered nurse, licensed pursuant to chapter 378.

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5514 where the local or regional board of education determines after consultation with the school medical advisor and the local health department, or in the case of a regional board of education, each local health department, that such tests are necessary, provided a registered nurse may only perform said tests pursuant to the written order of a physician or physician assistant, licensed pursuant to chapter 370, or an advanced practice registered nurse, licensed pursuant to chapter 378.

The assessment sHB5514shall /include: File No.

742 sHB5514 File No.

742 shall include:

The assessment shall also include tests for tuberculosis and sickle cell anemia or Cooley's anemia where the local or regional board of education, in consultation with the school medical advisor and the local health department, or in the case of a regional board of education, each local health department, determines that said screening orPublic testAct isNo. necessary, provided a registered nurse may only perform said tests pursuant to the written order of a physician or physician assistant, licensed pursuant to chapter 370, or an advanced practice registered nurse, licensed pursuant to chapter 378.

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5514 or test is necessary, provided a registered nurse may only perform said tests pursuant to the written order of a physician or physician assistant, licensed pursuant to chapter 370, or an advanced practice registered nurse, licensed pursuant to chapter 378.

The athletics assessment shall include a physical examination that shall include screening for serious cardiac conditions that could lead to sudden cardiac death, which screening shall be performed in sHB5514accordance /with Fileguidelines No.established by the American Heart Association, the American College of Cardiology or another organization focused on cardiovascular care in pediatric populations.

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742 accordance with guidelines established by the American Heart Association, the American College of Cardiology or another organization focused on cardiovascular care in pediatric populations.

[(d)] (e) The results of each assessment done pursuant to this section and the results of screenings done pursuant to section 10-214, as amendedPublic byAct [thisNo. act] public act 26-1, shall be recorded on forms supplied by the State Board of Education.

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5514 amended by [this act] public act 26-1, shall be recorded on forms supplied by the State Board of Education.

Each physician, advanced practice registered nurse, registered nurse, or physician assistant performing health assessments sHB5514and /screenings Filepursuant No.to this section and section 10-214, as amended by [this act] public act 26-1, shall completely fill out and sign each form and any recommendations concerning the pupil shall be in writing.

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742 and screenings pursuant to this section and section 10-214, as amended by [this act] public act 26-1, shall completely fill out and sign each form and any recommendations concerning the pupil shall be in writing.

[(f)] (g) On and after October 1, 2017, each local or regional board of education shall report to the local health department and the Department of Public Health,Act onNo. an triennial basis, the total number of pupils per school and per school district having a diagnosis of asthma (1) at the time of public school enrollment, (2) in grade six or seven, and (3) in grade nine or ten.

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5514 [(f)] (g) On and after October 1, 2017, each local or regional board of education shall report to the local health department and the Department of Public Health, on an triennial basis, the total number of pupils per school and per school district having a diagnosis of asthma (1) at the time of public school enrollment, (2) in grade six or seven, and (3) in grade nine or ten.

The report shall be submitted in accordance with the provisions of section 11-4a and shall include, but not be limited to, (A) trends and findings based on pupil age, gender, race, ethnicity, school and the education reference sHB5514group, /as Filedetermined No.by the Department of Education for the town or regional school district in which such school is located, and (B) activities of the asthma screening monitoring system maintained under section 19a-62a, as amended by this act.

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742 group, as determined by the Department of Education for the town or regional school district in which such school is located, and (B) activities of the asthma screening monitoring system maintained under section 19a-62a, as amended by this act.

Sec.Public Act No.

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5514 Sec.

(NEW) (Effective October 1, 2026) (a) The University of Connecticut Health Center's Health Disparities Institute, in consultation with the Department of Public Health, persons who have experienced symptoms of perimenopause, menopause and postmenopause, and health care providers who treat persons with symptoms of sHB5514perimenopause, /menopause Fileand No.postmenopause, shall develop, within available appropriations, a toolkit that provides practical, evidence- based and culturally appropriate guidance to health care providers in the state who are responsible for diagnosing or treating persons with symptoms of menopause, perimenopause or postmenopause, as determined by said institute, including, but not limited to, health care providers in the fields of obstetrics, gynecology, internal medicine, family medicine, emergency medicine, psychiatry, mental health, social work, dentistry, dental hygiene and community health, regarding best practices for screening, identification, clinical assessment, diagnosis and treatment of symptoms of menopause, perimenopause and postmenopause.

742Such sHB5514guidance Filemay include, but need not be limited to, (1) a comprehensive description of the symptoms of menopause, perimenopause and postmenopause, (2) evidence-based guidelines Public Act No.

74226-13 perimenopause,28 menopause and postmenopause, shall develop, within available appropriations, a toolkit that provides practical, evidence- based and culturally appropriate guidance to health care providers in the state who are responsible for diagnosing or treating persons with symptoms of menopause,73 perimenopauseSubstitute orHouse postmenopause,Bill asNo. determined by said institute, including, but not limited to, health care providers in the fields of obstetrics, gynecology, internal medicine, family medicine, emergency medicine, psychiatry, mental health, social work, dentistry, dental hygiene and community health, regarding best practices for screening, identification, clinical assessment, diagnosis and treatment of symptoms of menopause, perimenopause and postmenopause.

Such5514 guidance may include, but need not be limited to, (1) a comprehensive description of the symptoms of menopause, perimenopause and postmenopause, (2) evidence-based guidelines regardingtheidentificationandtreatmentofsuchsymptoms,including, but not limited to, the use of hormones, such as hormone replacement therapy and testosterone therapy, (3) the availability of insurance coverage for such therapies, and (4) short education modules regarding such guidance that would qualify as continuing education for such health care providers.

(1)"Designatedemployee" meansaschoolnurse ornurse practitioner appointed pursuant to section 10-212 of the general statutes, school nurse supervisor, school counselor, school social worker or school psychologist who a local or regional school board of education sHB5514designates /to Fileaccess No.safety plans of minor patients transmitted by health care providers to a school district or school's secure messaging system account pursuant to the provisions of this section;

742 sHB5514 File No.

742 designates to access safety plans of minor patients transmitted by health care providers to a school district or school's secure messaging system account pursuant to the provisions of this section;

(4) "Safety plan" means a written document created collaboratively betweenaPublic healthAct careNo. provider andapatientoutlining coping strategies, activities and support networks the patient can access to prevent or manage a potential mental health crisis;

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5514 betweena health care provider andapatientoutlining coping strategies, activities and support networks the patient can access to prevent or manage a potential mental health crisis;

If the minor patient or minor patient's parent or legally authorized representative consents to sharing such sHB5514safety /plan Filewith No.the minor patient's school, the health care provider shall obtain written consent from (A) the minor patient's parent or legally authorized representative, or (B) if the minor patient is sixteen years of age or older, such minor patient, and transmit such safety plan to the minor patient's school district or school (i) using a secure messaging system, or (ii) in a form and manner that complies with the Health Insurance Portability and Accountability Act of 1996, P.L.

742 sHB5514 File No.

742 safety plan with the minor patient's school, the health care provider shall obtain written consent from (A) the minor patient's parent or legally authorized representative, or (B) if the minor patient is sixteen years of age or older, such minor patient, and transmit such safety plan to the minor patient's school district or school (i) using a secure messaging system, or (ii) in a form and manner that complies with the Health Insurance Portability and Accountability Act of 1996, P.L.

(c)Public Nothing in this section shall be construed to (1) create a standard of medical care with respect to any minor patient, (2) require a health care provider to create a safety plan, (3) require a health care provider to release information to a parent or legally authorized representative if, pursuant to state or federal law, a minor patient may withhold such information from such minor patient's parent or legally authorized representative, including, but not limited to, information regarding pregnancy, abortion, contraceptives, human immunodeficiency virus or other sexually transmitted disease testing or treatment, mental health treatment or any other area of care that a health care provider has promised a minor patient that the health care provider will keep confidential, or (4) require a health care provider to transmit a safety plan or provide any other information to any person in violation of the provisions of the Health Insurance Portability and Accountability Act ofNo. 1996, P.L.

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5514 (c) Nothing in this section shall be construed to (1) create a standard of medical care with respect to any minor patient, (2) require a health care provider to create a safety plan, (3) require a health care provider to release information to a parent or legally authorized representative if, pursuant to state or federal law, a minor patient may withhold such information from such minor patient's parent or legally authorized representative, including, but not limited to, information regarding pregnancy, abortion, contraceptives, human immunodeficiency virus or other sexually transmitted disease testing or treatment, mental health treatment or any other area of care that a health care provider has promised a minor patient that the health care provider will keep confidential, or (4) require a health care provider to transmit a safety plan or provide any other information to any person in violation of the provisions of the Health Insurance Portability and Accountability Act of 1996, P.L.

A sHB5514designated /employee Fileshall No.retain minor patient safety plans in a confidential file separate from any cumulative academic or health record, provided information contained in a minor patient safety plan may be used to provide appropriate interventions pursuant to an individualized education program or a plan pursuant to Section 504 of the Rehabilitation Act of 1973.

742Public sHB5514Act File No.

74226-13 designated31 employee shall retain minor patient safety plans in a confidential file separate from any cumulative academic or health record, provided information contained in a minor patient safety plan may be used to provide appropriate interventions pursuant to an individualized education program or a plan pursuant to Section 504 of the73 RehabilitationSubstitute ActHouse ofBill 1973.No.

5514 (b) On or before April 1, 2027, each local or regional board of education shall submit each school district or school's secure messaging systemaddressto theCommissioner ofEducationinaformandmanner prescribed by the commissioner.

sHB5514(b) /It Fileshall No.be the goal of the State-wide Health Information Exchange to:

742 sHB5514 File No.

742 (b) It shall be the goal of the State-wide Health Information Exchange to:

(2) provide patients with secure electronic access to their health informationPublic inAct accordanceNo. with 45 CFR 171;

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5514 information in accordance with 45 CFR 171;

[and] (11) provide for broad local governance that (A) includes stakeholders, including, but not limited to, representatives of the Department of Social Services, hospitals, physicians, behavioral health care providers, long-term care providers, health insurers,employers,patientsandacademicinsurers, employers,patientsandacademic or medical research institutions, and (B) is committed to the successful development and implementation of the State-wide Health Information Exchange;

(1) "Abuse" means any act of abuse, as defined in 42 CFR 483.5, as amended from time to time, committed towards a client, resident or sHB5514patient; / File No.

742Public sHB5514Act File No.

74226-13 patient;33 of 73 Substitute House Bill No.

5514 [(1)] (2) "Commissioner" means the Commissioner of Public Health;

The grounds for sHB5514Public /Act File No.

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7425514 complaint shall include [resident abuse, resident neglect,] (1) illegal, incompetent or negligent conduct in the provision of nursing or nursing-related services, (2) abuse of a resident, patient or client, (3) neglect of a resident, patient or client, (4) misappropriation of resident, patient or client property, and (5) fraud or deceit in obtaining or attempting to obtain a registration as a nurse's aide.

Section 31-57e of the 2026 supplement to the general statutes isPublic amendedAct byNo. adding subsection (f) as follows (Effective from passage):

sHB551426-13 /35 Fileof 73 Substitute House Bill No.

7425514 sHB5514is Fileamended No.by adding subsection (f) as follows (Effective from passage):

742 (NEW) (f) The provisions of this section shall not apply to the provision of funds to a tribe pursuant to the Rural Health Transformation Program established pursuant to 42 USC 1397ee(h).

(NEW) (Effective October 1, 2026) The Recognition of EmergencyPublic MedicalAct Services Personnel Licensure Interstate Compact shall be enacted into law and entered into by the state of Connecticut with any and all states legally joining therein in accordance with its terms not earlier than one year after the date on which such compact is sHB5514 / File No.

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7425514 Emergency Medical Services Personnel Licensure Interstate Compact shall be enacted into law and entered into by the state of Connecticut with any and all states legally joining therein in accordance with its terms not earlier than one year after the date on which such compact is enacted in at least one of the states of Massachusetts, New York or Rhode Island.

(4)Public SupportAct licensingNo. of military members who are separating from an active-duty tour and their spouses;

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5514 (4) Support licensing of military members who are separating from an active-duty tour and their spouses;

sHB5514(6) /Promote Filecompliance No.with the laws governing EMS personnel practice in each member state;

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742 (6) Promote compliance with the laws governing EMS personnel practice in each member state;

(4) "Certification" means the successful verification of entry-level cognitivePublic andAct psychomotorNo. competency using a reliable, validated and legally defensible examination.

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5514 cognitive and psychomotor competency using a reliable, validated and legally defensible examination.

(6) "Emergency medical technician" or "EMT" means an individual licensed with cognitive knowledge and a scope of practice that corresponds to that level in the National EMS Education Standards and sHB5514National /EMS FileScope No.of Practice Model.

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742 National EMS Scope of Practice Model.

(14) "Restricted" means the outcome of an adverse action that limits a licensePublic orAct theNo. privilege to practice.

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5514 license or the privilege to practice.

(16) "Scope of practice" means defined parameters of various duties sHB5514or /services Filethat No.may be provided by an individual with specific credentials.

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742 or services that may be provided by an individual with specific credentials.

HOME STATE LICENSURE (a)Public AnyAct memberNo. state in which an individual holds a current license shall be deemed a home state for purposes of this compact.

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5514 (a) Any member state in which an individual holds a current license shall be deemed a home state for purposes of this compact.

(1) Currently requires the use of the National Registry of Emergency Medical Technicians (NREMT) examination as a condition of issuing sHB5514initial /licenses Fileat No.the EMT and paramedic levels;

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742 initial licenses at the EMT and paramedic levels;

COMPACT PRIVILEGE TO PRACTICE (a) Member states shall recognize the privilege to practice of an individualPublic licensedAct inNo. another member state that is in conformance with section 3 of this compact.

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5514 individual licensed in another member state that is in conformance with section 3 of this compact.

(c) An individual providing patient care in a remote state under the sHB5514privilege /to Filepractice No.shall function within the scope of practice authorized by the home state unless and until modified by an appropriate authority in the remote state as may be defined in the rules of the Commission.

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742 privilege to practice shall function within the scope of practice authorized by the home state unless and until modified by an appropriate authority in the remote state as may be defined in the rules of the Commission.

(f) If an individual's privilege to practice in any remote state is restricted,Public suspendedAct orNo. revoked, the individual shall not be eligible to practice in any remote state until the individual's privilege to practice is restored.

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5514 restricted, suspended or revoked, the individual shall not be eligible to practice in any remote state until the individual's privilege to practice is restored.

sHB5514(3) /The Fileindividual No.enters a remote state to provide patient care or transport within that remote state;

742 sHB5514 File No.

742 (3) The individual enters a remote state to provide patient care or transport within that remote state;

SECTIONPublic 7.Act No.

26-13 43 of 73 Substitute House Bill No.

5514 SECTION 7.

(c) All individuals functioning with a privilege to practice under this section shall remain subject to the adverse actions provisions of section 8 of this compact.

sHB5514SECTION /8. File No.

742 sHB5514 File No.

742 SECTION 8.

(2)AnPublic individualcurrentlyAct subjectNo. to adverseactioninthehome state shall not practice in any remote state without prior written authorization from both the home state and the remote state's EMS authority.

26-13 44 of 73 Substitute House Bill No.

5514 (2)An individualcurrently subject to adverseactioninthehome state shall not practice in any remote state without prior written authorization from both the home state and the remote state's EMS authority.

In such cases, the home state's law shall control in determining the appropriate sHB5514adverse /action. File No.

742 sHB5514 File No.

742 adverse action.

ADDITIONAL POWERS INVESTED IN A MEMBER STATE'S EMS AUTHORITY APublic memberAct state'sNo. EMS authority, in addition to any other powers granted under state law, is authorized under this compact to:

26-13 45 of 73 Substitute House Bill No.

5514 A member state's EMS authority, in addition to any other powers granted under state law, is authorized under this compact to:

The issuing state'sEMSauthorityshallpayanywitnessfees,travelexpenses,state'sEMSauthority shallpayanywitnessfees,travelexpenses, mileage andother feesrequiredby theservice statutesofthestate where the witnesses or evidence are located;

sHB5514(2) /Venue Fileis No.proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located.

742 sHB5514 File No.

742 (2) Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located.

(b)Public Membership,Act votingNo. and meetings (1) Each member state shall have and be limited to one delegate.

26-13 46 of 73 Substitute House Bill No.

5514 (b) Membership, voting and meetings (1) Each member state shall have and be limited to one delegate.

(4) All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the sHB5514rulemaking /provisions Filein No.section 12 of this compact.

742 sHB5514 File No.

742 rulemaking provisions in section 12 of this compact.

(B)Public TheAct employment,No. compensation, discipline or other personnel matters, practices or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;

26-13 47 of 73 Substitute House Bill No.

5514 (B) The employment, compensation, discipline or other personnel matters, practices or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;

(I) Disclosure of information related to any investigatory reports prepared by or on behalf of or for use of the Commission or other committeechargedwithresponsibilityofinvestigationordeterminationcommitteechargedwithresponsibilityofinvestigationor determination of compliance issues pursuant to the compact;

(6) If a meeting, or portion of a meeting, is closed pursuant to this provision, the Commission's legal counsel or designee shall certify that sHB5514the /meeting Filemay No.be closed and shall reference each relevant exempting provision.

742 sHB5514 File No.

742 the meeting may be closed and shall reference each relevant exempting provision.

All documents considered in connectionPublic withAct anNo. action shall be identified in such minutes.

26-13 48 of 73 Substitute House Bill No.

5514 connection with an action shall be identified in such minutes.

(E) Providing reasonable standards and procedures for the sHB5514establishment /of Filethe No.personnel policies and programs of the Commission.

742Notwithstanding sHB5514any Filecivil service or other similar laws of any member state, the bylaws shall exclusively govern the personnel Public Act No.

74226-13 establishment49 of the73 personnelSubstitute policiesHouse andBill programsNo. of the Commission.

Notwithstanding5514 any civil service or other similar laws of any member state, the bylaws shall exclusively govern the personnel policies and programs of the Commission;

(4) To borrow, accept or contract for services of personnel, including, sHB5514but /not Filelimited No.to, employees of a member state;

742Public sHB5514Act File No.

74226-13 but50 notof limited73 to,Substitute employeesHouse ofBill aNo. member state;

5514 (5) To hire employees, elect or appoint officers, fix compensation, define duties and grant such individuals appropriate authority to carry out the purposes of the compact and to establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel and other related personnel matters;

(11) To appoint committees, including advisory committees, comprised of members, state regulators, state legislators or their representatives and consumer representatives, and such other interested personsasmay bedesignatedinthisbedesignatedinthiscompact compact andthebylaws;

sHB5514Public /Act File No.

74226-13 sHB551451 Fileof 73 Substitute House Bill No.

7425514 (e) Financing of the Commission (1) The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities.

(f) Qualified immunity, defense and indemnification (1) The members, officers, executive director, employees and representativesPublic ofAct the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for sHB5514 / File No.

74226-13 sHB551452 Fileof 73 Substitute House Bill No.

7425514 representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basisfor believing occurred,withinthescopeofCommission employment, duties or responsibilities, provided nothing in this subdivision shall be construed to protect any such person from suit or liabilityforanydamage,loss,injuryorliabilitycausedbytheintentional or wilful or wanton misconduct of that person.

SECTIONPublic 11.Act No.

COORDINATED26-13 DATABASE53 (a)of The73 CommissionSubstitute shallHouse provideBill for the development and maintenance ofa coordinateddatabase andreporting systemcontaining sHB5514 / File No.

7425514 sHB5514SECTION File11. No.

742COORDINATED DATABASE (a) The Commission shall provide for the development and maintenance ofa coordinateddatabase andreporting systemcontaining licensure, adverse action and significant investigatory information on all licensed individuals in member states.

(d) Member states contributing information to the coordinated databasePublic mayAct designateNo. information that shall not be shared with the public without the express permission of the contributing state.

(e)26-13 Any54 information submitted to the coordinated database that is subsequently required to be expunged by the laws of the73 memberSubstitute stateHouse contributingBill the information shall be removed from the coordinated sHB5514 / File No.

7425514 sHB5514database Filemay No.designate information that shall not be shared with the public without the express permission of the contributing state.

742(e) Any information submitted to the coordinated database that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the coordinated database.

(1)Public TheAct proposedNo. time, date and location of the meeting in which the rule will be considered and voted upon;

26-13 55 of 73 Substitute House Bill No.

5514 (1) The proposed time, date and location of the meeting in which the rule will be considered and voted upon;

and sHB5514(4) /The Filemanner No.in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.

742 sHB5514 File No.

742 (4) The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.

(2) Hearings shall be conducted in a manner providing each person whoPublic wishesAct toNo. comment a fair and reasonable opportunity to comment orally or in writing.

26-13 56 of 73 Substitute House Bill No.

5514 who wishes to comment a fair and reasonable opportunity to comment orally or in writing.

(4) Nothing in this section shall be construed as requiring a separate sHB5514hearing /on Fileeach No.rule.

742 sHB5514 File No.

742 hearing on each rule.

(1)Public MeetAct anNo. imminent threat to public health, safety or welfare;

26-13 57 of 73 Substitute House Bill No.

5514 (1) Meet an imminent threat to public health, safety or welfare;

The revision shall sHB5514be /subject Fileto No.challenge by any person for a period of thirty days after posting.

742 sHB5514 File No.

742 be subject to challenge by any person for a period of thirty days after posting.

(2) All courts shall take judicial notice of the compact and the rules in any judicial or administrative proceeding in a member state pertaining toPublic theAct subjectNo. matter of this compact that may affect the powers, responsibilities or actions of the Commission.

26-13 58 of 73 Substitute House Bill No.

5514 to the subject matter of this compact that may affect the powers, responsibilities or actions of the Commission.

(A) Provide written notice to the defaulting state and other member states of the nature of the default, the proposed means of curing the sHB5514default /and Fileany No.other action to be taken by the Commission;

742 sHB5514 File No.

742 default and any other action to be taken by the Commission;

(4)Public AAct stateNo. that has been terminated is responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.

26-13 59 of 73 Substitute House Bill No.

5514 (4) A state that has been terminated is responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.

(c) Dispute resolution (1) Upon request by a member state, the Commission shall attempt to resolve disputes related to the compact that arise among member states sHB5514and /between Filemember No.and nonmember states.

742 sHB5514 File No.

742 and between member and nonmember states.

The relief sought may include bothPublic injunctiveAct reliefNo. and damages.

26-13 60 of 73 Substitute House Bill No.

5514 both injunctive relief and damages.

Any rule that sHB5514hasbeenpreviouslyadoptedbytheCommissionshallhavethefullforce /and Fileeffect No.of law on the day the compact becomes law in that state.

742 sHB5514 File No.

742 hasbeenpreviouslyadoptedbytheCommissionshallhavethefullforce and effect of law on the day the compact becomes law in that state.

(2) Withdrawal shall not affect the continuing requirement of the withdrawing state'sEMS authority to comply withtheinvestigative and adverse action reporting requirements of this act prior to the effective datePublic ofAct withdrawal.No.

26-13 61 of 73 Substitute House Bill No.

5514 date of withdrawal.

(NEW) (Effective October 1, 2026) On and after one year after the date on which the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact is enacted in at least one of the states of Massachusetts, New York or Rhode Island, in accordance with the provisions of section 28 of this act, the Commissioner of Public Health shall require any applicant for licensure or certification pursuant sHB5514to /the Fileprovisions No.of chapter 384d of the general statutes to submit to criminal history records checks, including state and national criminal history records checks, in accordance with the provisions of section 29- 17a of the general statutes as a condition of licensure or certification.

742 sHB5514 File No.

742 to the provisions of chapter 384d of the general statutes to submit to criminal history records checks, including state and national criminal history records checks, in accordance with the provisions of section 29- 17a of the general statutes as a condition of licensure or certification.

(NEW)(Effective October1,2026)Not later thanfive yearsafter the date on which the provisions of section 28 of this act are implemented, the Commissioner of Public Health, in consultation with the Secretary of the Office of Policy and Management, shall submit a reportPublic onAct suchNo. implementation, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committee of the General Assembly having cognizance of matters relating to public health.

26-13 62 of 73 Substitute House Bill No.

5514 report on such implementation, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committee of the General Assembly having cognizance of matters relating to public health.

Results submitted to the Department of Public Health or the local health authority pursuant to this subsection, information obtained from any Department of Public Health or local health authority investigation regarding those results and any Department of Public Health or local health authority study of morbidity and mortality regarding the results shall be confidential pursuant to section 19a-25, except the local health authority and the department may [, if approved by the commissioner,] disclose the results or information obtained from an investigation of the sHB5514results /to File(A) the owner of the property on which the well is located, the owner of any other property that obtains water from the well, and the owner of each property that is adjacent to the property on which the well is located or to any other property that obtains water from the well, (B) a prospective buyer of such property who has signed a contract to purchase such property, (C) other persons or entities, when such Public Act No.

74226-13 sHB551463 Fileof 73 Substitute House Bill No.

7425514 results to (A) the owner of the property on which the well is located, the owner of any other property that obtains water from the well, and the owner of each property that is adjacent to the property on which the well is located or to any other property that obtains water from the well, (B) a prospective buyer of such property who has signed a contract to purchase such property, (C) other persons or entities, when such disclosure is necessary to carry out a statutory or regulatory responsibility of the local health authority or department, [or] and (D) an agent of a state agency.

sHB5514(1) /"Direct Filesupervision" means a licensed dentist has authorized certain procedures to be performed on a patient by a dental assistant or an expanded function dental assistant with such dentist remaining on- site in the dental office or treatment facility while such procedures are Public Act No.

74226-13 sHB551464 Fileof 73 Substitute House Bill No.

7425514 (1) "Direct supervision" means a licensed dentist has authorized certain procedures to be performed on a patient by a dental assistant or an expanded function dental assistant with such dentist remaining on- site in the dental office or treatment facility while such procedures are being performed by the dental assistant or expanded function dental assistant and that, prior to the patient's departure from the dental office, such dentist reviews and approves the treatment performed by the dental assistant or expanded function dental assistant;

(2) "Indirect supervision" means a licensed dentist is in the dental office or treatment facility, has personally diagnosed the condition, planned the treatment, authorized the procedures to be performed and remains in the dental office or treatment facility while the procedures are being performed by thedental assistant or expandedfunctiondentalexpanded functiondental assistant and evaluates the performance of the dental assistant or expanded function dental assistant;

(A) An expanded function dental assistant program at an institution of higher education that is accredited by the Commission on Dental Accreditation of the American Dental Association that includes (i) educational courses relating to didactic and laboratory preclinical objectives for skills used by an expanded function sHB5514dental /assistant Fileand that requires demonstration of such skills prior to advancing to clinical practice, (ii) not less than four hours of education Public Act No.

74226-13 sHB551465 Fileof 73 Substitute House Bill No.

7425514 dental assistant and that requires demonstration of such skills prior to advancing to clinical practice, (ii) not less than four hours of education in the area of ethics and professional standards for dental professionals, and (iii) a comprehensive clinical examination administered by the institution of higher education at the conclusion of such program;

and (C) the provision sHB5514Public /Act File No.

74226-13 sHB551466 Fileof 73 Substitute House Bill No.

7425514 of fluoride varnish treatments.

(3)(A)Nolicenseddentistmaydelegatedentalprocedurestoadental assistant or expanded function dental assistant unless the dental assistant or expanded function dental assistant provides records demonstrating successful completion of the Dental Assisting National Board's infection control examination or an infection control competency assessment administered by a dental education program in the state that is accredited by the American Dental Association's CommissionPublic onAct Dental Accreditation, except as provided in subdivision (2) of this subsection, (B) a dental assistant may receive not more than fifteen months of on-the-job training by a licensed dentist for purposes sHB5514 / File No.

74226-13 sHB551467 Fileof 73 Substitute House Bill No.

7425514 Commission on Dental Accreditation, except as provided in subdivision (2) of this subsection, (B) a dental assistant may receive not more than fifteen months of on-the-job training by a licensed dentist for purposes of preparing the dental assistant for the infection control examinationor infection control competency assessment, and (C) any licensed dentist who delegates dental procedures to a dental assistant shall retain and make such records available for inspection upon request of the Department of Public Health.

(4) On and after January 1, 2018, upon successful completion of the Dental Assisting National Board's infection control examination or an infection control competency assessment administered by a dental educationprograminthestatethatisaccreditedbytheAmericanDentaleducationprograminthestatethatisaccreditedbythe AmericanDental Association's Commission on Dental Accreditation, each dental assistant or expanded function dental assistant shall complete not less than one hour of training or education in infection control in a dental setting every two years, including, but not limited to, courses, including online courses, offered or approved by a dental school or another institution of higher education that is accredited or recognized by the Commission on Dental Accreditation, a regional accrediting organization,theAmericanDentalAssociationorastate,districtorlocal dental association or society affiliated with the American Dental Association or the American Dental Assistants Association.

(5) the taking of any final impression of the teeth or jaws or the relationship of the teethPublic orAct jawsNo. for the purpose of fabricating any appliance or prosthesis;

26-13 68 of 73 Substitute House Bill No.

5514 teeth or jaws for the purpose of fabricating any appliance or prosthesis;

(e) Each licensed dentist employing or otherwise engaging the servicesofanexpandedfunctiondentalassistantshall:(1)Priortohiring or otherwise engaging the services of the expanded function dental sHB5514assistant, /verify Filethat No.the expanded function dental assistant meets the requirements described in subdivision (4) of subsection (a) and subdivisions (1) and (3) of subsection (b) of this section;

742 sHB5514 File No.

742 assistant, verify that the expanded function dental assistant meets the requirements described in subdivision (4) of subsection (a) and subdivisions (1) and (3) of subsection (b) of this section;

(NEW) (Effective October 1, 2026) (a) As used in this section, "cosmeticPublic injection"Act meansNo. a nonsurgical procedure involving the injection of a substance, including, but not limited to, botulinum toxin or dermal filler, to alter or enhance a person's physical appearance.

(b)26-13 A69 dentist licensed pursuant to chapter 379 of the73 generalSubstitute statutesHouse whoBill (1) has successfully completed an in-person hands-on training in the administration of cosmetic injections administered by a continuing education provider or program approved by the Commissioner of sHB5514 / File No.

7425514 sHB5514"cosmetic Fileinjection" No.means a nonsurgical procedure involving the injection of a substance, including, but not limited to, botulinum toxin or dermal filler, to alter or enhance a person's physical appearance.

742(b) A dentist licensed pursuant to chapter 379 of the general statutes who (1) has successfully completed an in-person hands-on training in the administration of cosmetic injections administered by a continuing education provider or program approved by the Commissioner of Public Health or accredited by a national professional accrediting body, and (2) maintains professional liability insurance that covers cosmetic injection procedures, may administer a cosmetic injection to a patient's face.

(e) The Commissioner of Public Health may adopt regulations, in accordance with chapter 54 of the general statutes, to implement the provisions of this section, including, but not limited to, minimum trainingPublic standards,Act approvedNo. training courses and patient safety requirements.

26-13 70 of 73 Substitute House Bill No.

5514 training standards, approved training courses and patient safety requirements.

The practice of dentistry or dental medicine is defined as the diagnosis, evaluation, prevention or treatment by surgical or other means, of an injury, sHB5514deformity, /disease Fileor No.condition of the oral cavity or its contents, or the jaws or the associated structures of the jaws.

742 sHB5514 File No.

742 deformity, disease or condition of the oral cavity or its contents, or the jaws or the associated structures of the jaws.

and (3) include not less than one contact hour of training or education in (A) any three of the [ten] twelve mandatory topics for continuing education activities prescribed by the commissionerPublic pursuantAct toNo. this subdivision, (B) [for registration periods beginning on and after October 1, 2016,] infection control in a dental setting, and (C) prescribing controlled substances and pain management.

26-13 71 of 73 Substitute House Bill No.

5514 commissioner pursuant to this subdivision, (B) [for registration periods beginning on and after October 1, 2016,] infection control in a dental setting, and (C) prescribing controlled substances and pain management.

For registration periods beginning on and after October 1, 2026, the commissioner, in consultation with said commission, shall on or before October 1, 2026, and biennially thereafter, issue a list that includes twelve mandatory topics, including, but not limited to, the provision of dental care to sHB5514persons /with Filean No.intellectual or developmental disability and identifying victimsofhumantrafficking,thatwillberequiredforthefollowingtwo- year registration period.

742 sHB5514 File No.

742 persons with an intellectual or developmental disability and identifying victimsofhumantrafficking,thatwillberequiredforthefollowingtwo- year registration period.

Sec.Public Act No.

26-13 72 of 73 Substitute House Bill No.

5514 Sec.

(Effective October 1, 2026) ThisGovernor's actAction: shall take effect as follows and shall amend the following sections:

SectionApproved 1May October14, 1, 2026 19a-490(a)Public Sec.Act No.

226-13 July73 1,of 202673 New section Sec.

3 July 1, 2026 New section Sec.

4 October 1, 2026 New section Sec.

5 from passage 17b-338(a) Sec.

6 from passage 19a-127l(d) Sec.

7 from passage 19a-515(b) Sec.

8 from passage 22a-430(g) Sec.

9 October 1, 2026 20-200 Sec.

10 from passage New section Sec.

11 October 1, 2026 19a-127k(j) sHB5514 / File No.

742 sHB5514 File No.

742 Sec.

12 October 1, 2026 New section Sec.

13 from passage New section Sec.

14 July 1, 2026 New section Sec.

15 July 1, 2026 10-206 Sec.

16 July 1, 2026 10-206a Sec.

17 July 1, 2026 19a-62a Sec.

18 October 1, 2026 New section Sec.

19 from passage New section Sec.

20 from passage New section Sec.

21 July 1, 2027 New section Sec.

22 from passage 17b-59d(b) Sec.

23 October 1, 2027 20-102aa Sec.

24 October 1, 2027 20-102cc(a) October 1, 2026 Sec.

25 19a-17(i) Sec.

26 from passage 31-57e(f) Sec.

27 October 1, 2027 20-102ee(a) Sec.

28 October 1, 2026 New section Sec.

29 October 1, 2026 New section Sec.

30 October 1, 2026 New section Sec.

31 October 1, 2026 19a-37(c)(1) October 1, 2026 Sec.

32 New section Sec.

33 October 1, 2026 20-112a Sec.

34 October 1, 2026 New section Sec.

35 October 1, 2026 20-123(a) Sec.

36 July 1, 2026 20-126c(b) Sec.

37 October 1, 2026 Repealer section sHB5514 / File No.

742 sHB5514 File No.

742 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 27 $ FY 28 $ UConn Health Ctr.

OF - Cost Up to Up to 113,500 113,500 UConn Health Ctr.

OF - See Below See Below See Below Public Health, Dept.

GF - Revenue Potential Potential Gain Minimal Minimal Public Health, Dept.

GF - Revenue See Below See Below Loss Public Health, Dept.

GF - Potential Minimal Minimal Cost Legislative Mgmt.

GF - Potential Minimal Minimal Cost Department of Emergency GF - Potential See Below See Below Services and Public Protection Cost Mental Health & Addiction GF - Potential See Below See Below Serv., Dept.;

Department of Cost Developmental Services;

Social Services, Dept.

Resources of the General Fund GF - Potential See Below See Below Revenue Gain Department of Emergency Applicant See Below See Below Services and Public Protection Fingerprint Card Submission Account - Potential Revenue Gain Note:

GF=General Fund;

OF=Operating Fund sHB5514 / File No.

742 70 sHB5514 File No.

742 Municipal Impact:

Municipalities Effect FY 27 $ FY 28 $ Various Municipal Police Potential See Below See Below Departments Revenue Gain Local and Regional School STATE None Potential Districts MANDATE 1 Minimal - Potential Cost Explanation The bill makes variouschanges to thepublic health statutes,resulting in the fiscal impacts described below.

Section 12 results in both a potential revenue loss and a potential savings, annually beginning in FY 27, to the UConn Health Center (UCHC).

It allows hospital emergency departments to administer certain drugs to patients presenting with symptoms of substance use disorder without requiring in-patient admission.

Any impacts will be half-year in FY 27 as the requirements take effect 1/1/27.

The bill may reduce the number of in-patient admissions to UCHC, to the extent that patients may have otherwise been admitted for this treatment.

If a reduction in in-patient admissions occurs, the net impact will depend on the payer mix of those patients.

A reduction in privately insured admissions would result in a revenue loss to UCHC, while a reduction in uninsured or underinsured admissions would result in a savings.

The bill additionally results in a potential cost to UCHC annually beginning in FY 27 by allowing UCHC to offer an opioid antagonist, or a prescription for an opioid antagonist, to patients presenting to the emergency department with symptoms of substance use disorder.

To the extent that this increases the number of opioid antagonists provided State mandate is defined in Sec.

2-32b(2) of the Connecticut General Statutes, "state mandate" means any state initiated constitutional, statutory or executive action that requires a local government to establish, expand or modify its activities in such a way as to necessitate additional expenditures from local revenues.

sHB5514 / File No.

742 71 sHB5514 File No.

742 without payment from patients or insurance, there is a cost to UCHC of $35 to $50 per unit.

The annualized ongoing fiscal impact would continue into the future subject to the number changes in UCHC inpatient admissions, the payer mix of those patients, and the number of opioid antagonists UCHC provides, if any.

Section 13 creates an endometriosis working group and allows members to be reimbursed for any necessary expenses incurred in the performance of their duties.

This results in a potential minimal cost to the Office of Legislative Management beginning in FY 27 to the extent reimbursements are requested.

Section 14 establishes an advisory council on chimeric antigen receptor (CAR) T-cell therapy and other gene therapies within the Department of Public Health (DPH) for administrative purposes only.

This results in a potential minimal cost to DPH beginning in FY 27, as council members may be reimbursed for necessary expenses incurred in performing their duties.

Additionally, the council may:

(1) procure certain grants, gifts, bequests, sponsorships and in-kind donations for the purpose of carrying out its responsibilities;

and (2) enter into any contracts or agreements necessary for the distribution or use of any received funds, services or property.

Sections 15 and 16 require high school student athletes to complete an athletics health assessment and local and regional boards of education (BOEs) to pay for the assessment for certain students, resulting in a potentially minimal cost to BOEs beginning in FY 28.

The cost is dependent on the number of students for whom the BOE must pay for the assessment and the cost of the assessment.

It is anticipated the cost of the assessment will be minimal and may be covered by 2A box of Narcan costs about $35 to $50 and contains two doses.

sHB5514 / File No.

742 72 sHB5514 File No.

742 insurance for some students.

Section 18 results in a cost to the UConn Health Center (UCHC) of up to $113,500 in both FY 27 and FY 28 and up to $21,500 in FY 29.

It requires the UCHC Health Disparities Institute to develop a menopause toolkit.

Given the scope of the project, it is anticipated that UCHC will incur staff costs in FY 27 and FY 28 of $82,000 annually to hire a part-time Project Coordinator and a part-time Instructional Designer to complete the tool kit.

UCHC will incur additional costs (in both FY 27 and FY 28) of up to $31,500 for supplies and materials.

It is anticipated UCHC will incur a cost of up to $21,500 in FY 29 to update the toolkit.

Sections 24 and 25 expand DPH authority to take disciplinary action against nurse’s aides and Rural Health Transformation (RHT) practitioners that commit specified misconduct, resulting in a potential minimal revenue gain to the General Fund beginning in FY 27.

Section 26 makes procedural changes that allow tribes to receive RHT Program funding without taking employment rights-related steps.

Section 28 enters Connecticut into the Emergency Medical Services (EMS) compact, resulting in a General Fund annual revenue loss of up 4 to an estimated $31,000 due to the loss of paramedic licensure renewal fees ($155 each ) associated with individuals who are also licensed within other participating compact states.

Of this total, $1,000 is a CGS Sec.

19a-17 gives DPH the authority to assess a civil penalty of up to $25,000 to professionals under its jurisdiction as part of its disciplinary practices.

It is anticipated that DPH will receive up to 199 fewer paramedic renewals in the first year of joining the compact based on current DPH licenses held by paramedics in compact and neighboring states, assuming all neighbor states join the compact.

Paramedics are the only EMS provider license or certification covered by the compact with any associated fees in Connecticut.

A conflict of provisions in PA 25-198 and PA 25-174 reconciled pursuant to CGS Sec.

2-30b eliminated the initial application fee, but not the renewal fee.

Of each $155 renewal fee, $150 is directly deposited into the General Fund.

The remaining $5 fee is deposited into the professional assistance program account which supports the Health Assistance InterVention Education Network (HAVEN).

sHB5514 / File No.

742 sHB5514 File No.

742 revenue loss to the professional assistance program account that supports the Health Assistance InterVention Education Network (HAVEN).

The revenue loss would begin one year after Massachusetts, New York, or Rhode Island enacts the EMS compact, and continue annually thereafter, as this triggers Connecticut's adoption of the compact.

The revenue loss may be partially offset to the extent Connecticut DPH charges a fee to out-of-state paramedics for granting compact privilege.

Currently, the state does not directly charge a separate fee for privileges granted by any similar interstate occupational compacts.

Additionally, the EMS compact allows the United States EMS Compact Commission to levy an annual assessment on member states to cover the cost of its operations;

however, such authority has never imposed any state assessments or fees.

The Compact Commission is presently funded through a multi-year grant provided by the National Registry of EMTs.

Section 29 requires, beginning one year after a neighboring state enacts the EMS compact, applicants for EMS licensure and certification to submit to a state and national fingerprint-based criminal history records check, resulting in:

(1) a potential cost to the Department of Emergency Services and Public Protection (DESPP), (2) a potential revenue gain to the General Fund, and (3) a potential revenue gain to the Applicant Fingerprint Card Submission Account and various municipal police departments.

These fiscal impacts would further depend on the volume of license and certification applications subject to this requirement, which is unknown.

9 7DESPP conducts state criminal history records checks for a fee of $75.

The revenue that is collected from this fee is deposited into the General Fund.

8DESPP conducts fingerprinting for a fee of $15 per person paid to the Applicant Fingerprint Card Submission Account.

Municipal police departments may also conduct the required fingerprinting for state criminal history records checks and typically charge a fee of $10 to $15.

9For context, DPH issued 2,375 new EMS licenses and certifications in FY 25.

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742 The fiscal impacts identified above will continue in the future subject to the timing of a neighboring state joining the EMS compact and the number of criminal history records checks subsequently performed by DESPP and various municipal police departments for EMS applicants.

Section 37 may result in a cost to the state beginning in FY 27 associated with removing salary cost caps for purposes of contracting with certain providers.

Currently, when determining state payments to any organization or facility providing employment opportunitiesor day services,or services ina residentialfacility to personsreferredthere by thestate, state statute limits the total cost allowance for the associated director’s salary.

The same limitation applies when determining the amount of any Department of Mental Health and Addiction Services grant to provide services to mentally ill persons.

The bill could therefore result in a cost to the state to the extent agencies consider higher salary costs when contracting for relevant services.

House "A" strikes the underlying bill and its associated fiscal impact, resulting in the impacts described above.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to (1) when the EMS compact becomes effective and (2) inflation in nonprofit provider director salaries.

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742 OLR Bill Analysis sHB 5514 (as amended by House "A")* AN ACT CONCERNING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES.

TABLE OF CONTENTS:

SUMMARY § 1 — HEALTH CARE FACILITIES OPERATED BY EDUCATIONAL FACILITIES Allows an infirmary operated by an educational institution to care for dependent family members of students, faculty, and employees when they are enrolled in the institution’s health plan § 2 — WORKING GROUP ON MANAGED RESIDENTIAL COMMUNITIES Requires the DPH commissioner to establish a working group to advise the department on managed residential communities in the state that provide assisted living services and whether these communities should be licensed by the state § 3 — NONPROFIT DISTRIBUTION OF FREE EYEGLASSES Allows nonprofits that give free eyeglasses to give them to the person’s authorized representative if the person is unavailable to receive them from the organization in-person § 4 — PATIENT NOTICE ON MEDICAL RECORDS RETENTION Requires health care providers to notify patients in writing at their initial intake about the amount of time the law requires the provider to keep their medical records and how the patient can request copies of them §§ 5-7 — TECHNICAL CHANGES Makes technical changes to update the name of LeadingAge Connecticut to Leading Age Connecticut and Rhode Island in statute § 8 — SEWAGE DISPOSAL AND NITROGEN REMOVAL Requires the DPH and DEEP commissioners, by July 1, 2028, to consult with nitrogen removal experts to establish procedures and sHB5514 / File No.

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742 standards for reviewing and approving new nitrogen removal technologies for DPH-regulated subsurface sewage disposal systems § 9 — TEMPORARY VETERINARY PERMITS Under specified conditions, allows DPH to issue a temporary veterinarian permit to graduates of foreign veterinary schools, allowing them to work under direct supervision of certain state- licensed veterinarians § 10 — VETERINARY TELEHEALTH WORKING GROUP Creates a working group to evaluate the feasibility of establishing a veterinary-client-patient-relationship through telehealth § 11 — HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENTS Requires hospitals, when conducting a community health needs assessment, to (1) consider including the nutritional needs of community members with diabetes and congestive heart failure and (2) include these community members’ nutrition needs in their assessment to the extent federal law allows § 12 — BRIDGE PROGRAM FOR EMERGENCY OPIOID USE DISORDER TREATMENT Generally allows hospitals to (1) administer buprenorphine or methadone to someone who comes to the emergency department with symptoms of opioid use disorder without requiring them to be admitted;

(2) offer these patients an opioid antagonist prescription when discharged and refer them to outpatient care;

and (3) give these patients, when discharged, either a bridging dose or last dose letter (depending on the medication) § 13 — ENDOMETRIOSIS WORKING GROUP Establishes a 20-member endometriosis working group in the Legislative Department to evaluate and make recommendations on endometriosis diagnosis, treatment, research, education, and public awareness § 14 — ADVISORY COUNCIL ON CHIMERIC ANTIGEN RECEPTOR T- CELL THERAPY Establishes a 20-member advisory council on CAR T-cell therapy to advise and make recommendations to DPH and other state agencies related to these therapies;

requires the council to report annually to the Insurance and Real Estate and Public Health committees §§ 15-17 — ATHLETIC HEALTH ASSESSMENTS FOR HIGH SCHOOL STUDENT ATHLETES sHB5514 / File No.

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742 Generally requires public high school students, before playing interscholastic sports, to have an annual athletics health assessment to screen for serious cardiac conditions § 18 — MENOPAUSE PROVIDER TOOLKIT Requires UConn’s Health Disparities Institute to (1) develop a menopause toolkit for specified providers who diagnose or treat people with symptoms of menopause, perimenopause, and post- menopause;

(2) distribute the toolkit to providers by June 1, 2028;

and (3) distribute a revised toolkit by January 1, 2029, based on provider feedback §§ 19-22 — SCHOOL SAFETY PLANS Sets requirements for health care providers to share certain minors’ safety plans with schools §§ 23, 24 & 27 — NURSE’S AIDES Starting in October 2027, expands DPH’s nurse’s aide registry to include nurse’s aides working at any DPH-licensed health care institution, rather than just nursing homes as under current law, and makesrelated changesto expandDPH’sauthorityto take disciplinary action against nurse’s aides who commit specified misconduct §§ 25 & 26 — RURAL HEALTH TRANSFORMATION PROGRAM Allows DPH to take disciplinary action against a practitioner for failing to fulfill any material obligation resulting from the receipt of funding from DPH under the federally-funded Rural Health Transformation program;

exempts program funding to the tribes from the general requirement that they first adopt an Employment Rights Code before the state can provide funds that assist a tribe engaged in a commercial enterprise §§ 28-30 — EMS LICENSURE INTERSTATE COMPACT AND BACKGROUND CHECKS Enters Connecticut into the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact, no earlier than one year after a neighboring state enters it;

correspondingly requires DPH to institute a criminal background check requirement for EMS personnel (starting one year after a neighboring state enters the compact);

requires DPH to report on the compact’s implementation within five years after the state enters it § 31 — WELL WATER TESTING RESULTS sHB5514 / File No.

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