SB 93 — AN ACT IMPLEMENTING THE RURAL HEALTH TRANSFORMATION PROGRAM TO EXPAND HEALTH CARE ACCESS.

(11) "Privilege to practice" means an individual's authority to deliver emergency medical services in remote states as authorized under this compact.sSB93 / File No.

44 6 sSB93 File No.

44 compact.

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

610 6 of 29 Governor's Bill No93 (16) "Scope of practice" means defined parameters of various duties or services that may be provided by an individual with specific credentials.

(18)sSB93 "State"/ meansFile anyNo. state, commonwealth, district or territory of the United States.

44 7 sSB93 File No.

44 (18) "State" means any state, commonwealth, district or territory of the United States.

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

610 7 of 29 Governor's Bill No93 (1) Currently requires the use of the National Registry of Emergency Medical Technicians (NREMT) examination as a condition of issuing initial licenses at the EMT and paramedic levels;

and (5)sSB93 Complies/ withFile theNo. rules of the Commission.

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44 (5) Complies with the rules of the Commission.

and LCO(3) No.Practice under the supervision of a medical director.

610 8 of 29 Governor's Bill No93 (3) Practice under the supervision of a medical director.

(f)sSB93 If/ anFile individual'sNo. privilege to practice in any remote state is 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.

44 9 sSB93 File No.

44 (f) If an individual's privilege to practice in any remote state is 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.

(1) The individual originates a patient transport in a home state and LCOtransports No.the patient to a remote state;

610 9 of 29 Governor's Bill No93 transports the patient to a remote state;

RELATIONSHIP TO EMERGENCY MANAGEMENT ASSISTANCE COMPACT UponUponamemberstate'sGovernor'sdeclarationofastateofemergency a member state's governor's declarationof a state of emergency or disaster that activates the Emergency Management Assistance Compact (EMAC), all relevant terms and provisions of EMAC shall apply and to the extent any terms or provisions of this compact conflict with EMAC, the terms of EMAC shall prevail with respect to any individual practicing in the remote state in response to such declaration.

VETERANS, SERVICE MEMBERS SEPARATING FROMsSB93 ACTIVE-DUTY/ MILITARYFile ANDNo. THEIR SPOUSES (a) Member states shall consider a veteran, active military service member and member of the National Guard and Reserve separating from an active-duty tour, and a spouse thereof, who holds a current valid and unrestricted NREMT certification at or above the level of the state license being sought as satisfying the minimum training and examination requirements for such licensure.

(b)44 Member10 statessSB93 shallFile expedite the processing of licensure applications submitted by veterans, active military service members LCO No.

61044 10FROM ofACTIVE-DUTY 29MILITARY Governor'sAND BillTHEIR No93SPOUSES (a) Member states shall consider a veteran, active military service member and membersmember of the National Guard and Reserve separating from an active-duty tour, and theira spouses.spouse thereof, who holds a current valid and unrestricted NREMT certification at or above the level of the state license being sought as satisfying the minimum training and examination requirements for such licensure.

(b) Member states shall expedite the processing of licensure applications submitted by veterans, active military service members and members of the National Guard and Reserve separating from an active-duty tour, and their spouses.

(c)sSB93 A/ memberFile stateNo. shall report adverse actions and any occurrences that the individual's compact privileges are restricted, suspended or revoked to the Commission in accordance with the rules of the Commission.

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44 (c) A member state shall report adverse actions and any occurrences that the individual's compact privileges are restricted, suspended or revoked to the Commission in accordance with the rules of the Commission.

(e)Any member state may take adverse actionagainst an individual's LCOprivilege No.to practice in that state based onthefactual findings of another member state, so long as each state follows its own procedures for imposing such adverse action.

610 11 of 29 Governor's Bill No93 privilege to practice in that state based onthefactual findings of another member state, so long as each state follows its own procedures for imposing such adverse action.

Subpoenas issued by a member state's EMS authority for the attendance and testimony of witnesses or the production of evidence from another member state shall be enforced in the remote state by any courtsSB93 of/ competentFile jurisdictionNo. according to that court's practice and procedure in considering subpoenas issued in its own proceedings.

44 12 sSB93 File No.

44 court of competent jurisdiction according to that court's practice and procedure in considering subpoenas issued in its own proceedings.

and (2) Issue cease and desist orders to restrict, suspend or revoke an LCOindividual's No.privilege to practice in the state.

610 12 of 29 Governor's Bill No93 individual's privilege to practice in the state.

In the event that more than one board, office or other agency with the legislative mandate to licensesSB93 EMS/ personnelFile atNo. and above the level of EMT exists, the governor of the state shall determine which entity will be responsible for assigning the delegate.

(2)44 Each13 delegatesSB93 shallFile be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have LCO No.

61044 13license ofEMS 29personnel Governor'sat Billand No93above anthe opportunitylevel toof participateEMT inexists, the businessGovernor andof affairsthe ofstate shall determine which entity will be responsible for assigning the Commission.delegate.

(2) Each delegate shall be entitled to one vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission.

(G)sSB93 Disclosure/ ofFile informationNo. of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

(H)Disclosureofinvestigatoryrecordscompiledforlawenforcement44 LCO14 sSB93 File No.

61044 14(G) Disclosure of 29information Governor'sof Billa No93personal purposes;nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

(H)Disclosureofinvestigatoryrecordscompiledforlawenforcement purposes;

(C)sSB93 Providing/ reasonableFile procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all LCO No.

61044 15 ofsSB93 29File Governor'sNo. Bill No93 meetingsandproviding anopportunity for attendance ofsuch meetings by interested parties, with enumerated exceptions designed to protect the public's interest, the privacy of individuals and proprietary information, including trade secrets.

44 (C) Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetingsandproviding anopportunity for attendance ofsuch meetings by interested parties, with enumerated exceptions designed to protect the public's interest, the privacy of individuals and proprietary information, including trade secrets.

and (G) Providing a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of the compact and after the payment or reserving of all of its debts and obligations.

(d)sSB93 The/ CommissionFile shallNo. have the following powers:

LCO44 16 sSB93 File No.

61044 16(d) of 29 Governor's Bill No93 (1) The authorityCommission toshall promulgatehave uniformthe rulesfollowing topowers: facilitate and coordinate implementation and administration of this compact.

(1) The authority to promulgate uniform rules to facilitate and coordinate implementation and administration of this compact.

(2) To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state EMS authority or other regulatory body responsible for EMS personnel licensure to sue or be sued under applicable law shall not be affected;

LCOsSB93 / File No.

61044 17 ofsSB93 29File Governor'sNo. Bill No93 (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 bedesignatedinthiscompact andthebylaws;

44 (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 bedesignatedinthiscompact andthebylaws;

(4) The Commission shall not incur obligations of any kind prior to securing thefundsadequate to meetthesame,normeetthesame, nor shalltheCommission pledge the credit of any of the member states, except by and with the authority of the member state.

LCOsSB93 / File No.

61044 18 ofsSB93 29File Governor'sNo. Bill No93 (5) The Commission shall keep accurate accounts of all receipts and disbursements.

44 (5) The Commission shall keep accurate accounts of all receipts and disbursements.

(f) Qualified immunity, defense and indemnification (1) The members, officers, executive director, employees and 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,occurred,withinthescopeofCommission 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.

(3) The Commission shall indemnify and hold harmless any member, LCOofficer, executive director, employee or representative of the Commission for the amount of any settlement or judgment obtained sSB93 / File No.

61044 19 ofsSB93 29File Governor'sNo. Bill No93 officer, executive director, employee or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided the actual or alleged act, error or omission did not result from the intentional or wilful or wanton misconduct of that person.

44 against that person arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided the actual or alleged act, error or omission did not result from the intentional or wilful or wanton misconduct of that person.

(7) Any denial of application for licensure and the reason or reasons LCOfor No.such denial;

610 20 of 29 Governor's Bill No93 for such denial;

(c)sSB93 The/ coordinatedFile databaseNo. administrator shall promptly notify all member states of any adverse action taken against, or significant investigative information on, any individual in a member state.

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44 (c) The coordinated database administrator shall promptly notify all member states of any adverse action taken against, or significant investigative information on, any individual in a member state.

LCO(1) No.On the Internet web site of the Commission;

610 21 of 29 Governor's Bill No.93 (1) On the Internet web site of the Commission;

(e)sSB93 The/ NoticeFile ofNo. Proposed Rulemaking shall include:

44 21 sSB93 File No.

44 (e) The Notice of Proposed Rulemaking shall include:

LCO(1) No.All persons wishing to be heard at the hearing shall notify the executive director of the Commission or other designated member in writing of their desire to appear and testify at the hearing not less than five business days before the scheduled date of the hearing.

610(2) 22Hearings ofshall 29 Governor's Bill No93 (1) All persons wishing to be heardconducted atin thea hearingmanner shallproviding notifyeach theperson executivewho directorwishes ofto thecomment Commissiona orfair otherand designatedreasonable memberopportunity in writing of their desire to appearcomment andsSB93 testify/ atFile theNo. hearing not less than five business days before the scheduled date of the hearing.

(2)44 Hearings22 shallsSB93 beFile conductedNo. in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.

44 orally or in writing.

(l) Upon determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment or hearing, provided the usual rulemaking procedures provided in the compact and in this section shall be LCOretroactively No.applied to the rule as soon as reasonably possible, in no event later than ninety days after the effective date of the rule.

610 23 of 29 Governor's Bill No93 retroactively applied to the rule as soon as reasonably possible, in no event later than ninety days after the effective date of the rule.

(3)sSB93 Meet/ aFile deadlineNo. for the promulgation of an administrative rule that is established by federal law or rule;

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44 (3) Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule;

LCO(2) No.All courts shall take judicial notice of the compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this compact that may affect the powers, responsibilities or actions of the Commission.

610 24 of 29 Governor's Bill No93 (2) All courts shall take judicial notice of the compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this compact that may affect the powers, responsibilities or actions of the Commission.

Failure to provide service of process to the Commission shall render a judgment or order void as to the Commission,sSB93 this/ compactFile orNo. promulgated rules.

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44 Commission, this compact or promulgated rules.

Notice of intent to suspend or terminate shall be given by the Commission to the governor,Governor and the majority and minority leaders of the defaulting state's legislaturelegislature, and each of the member states.

LCO(4) No.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.

610 25 of 29 Governor's Bill No93 (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.

(6)sSB93 The/ defaultingFile stateNo. may appeal the action of the Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices.

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44 (6) The defaulting state may appeal the action of the Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices.

In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such LCOlitigation, No.including reasonable attorney's fees.

610 26 of 29 Governor's Bill No93 litigation, including reasonable attorney's fees.

DATE OF IMPLEMENTATIONIMPLEMENTATIONOF OF THE INTERSTATE COMMISSION FOR EMS PERSONNEL PRACTICE AND ASSOCIATED RULES, WITHDRAWAL AND AMENDMENT (a) The compact shall come into effect on the date on which the compactsSB93 statute/ isFile enactedNo. into law in the tenth member state.

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44 compact statute is enacted into law in the tenth member state.

(d) Nothing contained in this compact shall be construed to invalidate or prevent any EMS personnel licensure agreement or other LCOcooperative No.arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact.

610 27 of 29 Governor's Bill No.93 cooperative arrangement between a member state and a nonmember state that does not conflict with the provisions of this compact.

If this compact shall be held contrary to the constitution of any state member thereto, the compact shall remain in fullsSB93 force/ andFile effectNo. as to the remaining member states.

44 27 sSB93 File No.

44 full force and effect as to the remaining member states.

6.7.

(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 theprovisionsofsection5ofthistheprovisionsofsection6ofthis act,act,theCommissioner theCommissioner ofPublicHealth shall require any applicant for licensure or certification pursuant 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.

Section 1 October 1, 2027 Section 1 20-102aa Sec.

5 October 1, 20262027 New20-102ee(a) section Sec.

6 October 1, 2026 New section LCOSec. No.

6107 28October of1, 292026 Governor'sNew Billsection No.PH Joint Favorable Subst.

93sSB93 Statement/ ofFile Purpose:No.

To44 implement28 thesSB93 Governor'sFile budgetNo. recommendations.

[Proposed44 deletionsThe following Fiscal Impact Statement and Bill Analysis are enclosedprepared infor brackets.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.

ProposedIn additionsgeneral, arefiscal indicatedimpacts byare underline,based exceptupon that when the entire text of a billvariety or resolution or a section of ainformational billsources, orincluding resolutionthe isanalyst’s new,professional itknowledge. is not underlined.] LCO No.

610Whenever 29applicable, agency data is consulted as part of 29the 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 $ Public Health, Dept.

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

GF - Revenue See Below See Below Loss Department of Emergency GF - Potential See Below See Below Services and Public Protection Cost 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 Municipal Impact:

Municipalities Effect FY 27 $ FY 28 $ Various Municipal Police Potential See Below See Below Departments Revenue Gain Explanation The bill makes various changes implementing the Rural Health Transformation (RHT) Program, including the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact (EMS compact), resulting in several fiscal impacts described below.

Sections 1 and 5 expand the Department of Public Health’s (DPH's) nurse’s aide registry to include nurse’s aides working with any licensed sSB93 / File No.

44 29 sSB93 File No.

44 health care institution, resulting in no fiscal impact.

Sections 2 and 3 expand DPH authority to take disciplinary action against nurse’s aides and RHT practitioners that commit specified misconduct, resulting in a potential minimal revenue gain to the General Fund beginning in FY 27.

Section 4 makes procedural changes that allow tribes to receive RHT Program funding without taking employment rights-related steps.

Section 6 enters Connecticut into the EMS compact, resulting in a General Fund annual revenue loss of up 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 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 1CGS Sec.

19a-17 gives DPH the authority to assess a civil penalty of up to $25,000 to 2rofessionals 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.

3Paramedics 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).

sSB93 / File No.

44 30 sSB93 File No.

44 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 7 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.

7 The Out Years 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.

5DESPP 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.

6DESPP 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.

7For context, DPH issued 2,375 new EMS licenses and certifications in FY 25.

sSB93 / File No.

44 31 sSB93 File No.

44 OLR Bill Analysis sSB 93 AN ACT IMPLEMENTING THE RURAL HEALTH TRANSFORMATION PROGRAM TO EXPAND HEALTH CARE ACCESS.

SUMMARY This bill:

1.

expands the Department of Public Health (DPH) 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 makes related changes to expand DPH’s authority to take disciplinary action against nurse’s aides who commit specified misconduct (§§ 1, 2 & 5);

2.

allows DPH, or its licensing boards or commissions, to take disciplinary action against a practitioner for failing to fulfill any obligation resulting from the receipt of funding from DPH under the federally-funded Rural Health Transformation (RHT) Program (§ 3);

3.

exempts funding to the Mashantucket Pequot or Mohegan tribe under the RHT program from the law’s general requirement that a tribe must first adopt an Employment Rights Code before the state can provide funds that assist a tribe engaged in a commercial enterprise (§ 4);

4.

enters Connecticut into the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact, no earlier than one year after a neighboring state enters it (the compact creates a process authorizing emergency medical services (EMS) personnelwhoarelicensedinonememberstatetopracticeacross state boundaries without requiring licensure in each state) (§ 6);

sSB93 / File No.

44 32 sSB93 File No.

44 and 5.

corresponding to a compact requirement, requires DPH to institute a criminal background check requirement for EMS personnel (starting one year after a neighboring state enters the compact) (§ 7).

EFFECTIVE DATE:

October 1, 2026, except that the tribal-related provision (§ 4) takes effect upon passage, and the nurse’s aide-related provisions (§§ 1, 2 & 5) take effect October 1, 2027.

§§ 1, 2 & 5 — NURSE’S AIDES The bill expands DPH’s nurse’s aide registry to include nurse’s aides working (as direct employees or under a contract) with any DPH- licensed health care institution, rather than just nursing homes as under current law.

Under existing law, a nurse’s aide must meet specified training and exam requirements to be registered.

The bill correspondingly expands DPH’s authority to receive and investigate complaints and take disciplinary actions against nurse’s aides to include those who work at any DPH-licensed institution.

Under current law, the grounds for complaints against nurse’s aides (just in nursing homes) include, among other things, resident abuse or neglect.

The bill specifies that this applies to “abuse” or “neglect,” as defined in specified federal regulations for long-term care facilities (42 C.F.R.

§ 483.5), of a healthcare institution resident, patient, or client.

The bill also expands the grounds for complaints to include illegal, incompetent, or negligent conduct in providing nursing or related services.

The bill authorizes DPH to issue a summary suspension of a nurse’s aide’s ability to practice before the final decision on a complaint or duringtheappealsprocess.ThisauthorityappliesonlyifDPHfinds that a nurse’s aide represents a clear and immediate danger if allowed to continue to practice.

The bill also allows DPH, in line with existing procedures, to take disciplinary action against a nurse’s aide after it investigates a sSB93 / File No.

44 33 sSB93 File No.

44 complaint.

By law, disciplinary actions available to DPH include, among other things, (1) revoking or suspending a credential;

(2) censuring the violator;

(3) issuing a letter of reprimand;

(4) placing the violator on probationary status;

or (5) imposing a civil penalty of up to $25,000 (CGS § 19a-17).

Under existing law, DPH can also render a finding against someone who is or has provided nurse’s aide services and enter the finding in the registry, regardless of whether the aide is on the registry.

The bill also makes minor and conforming changes.

§§ 3 & 4 — RURAL HEALTH TRANSFORMATION PROGRAM The bill allows DPH, or its licensing boards or commissions, to take disciplinary action (see above) against a practitioner who fails to fulfill any obligation resulting from receiving DPH funding under the RHT program.

Generally, under existing law, before the state can give funds to help the Mashantucket Pequot or Mohegan tribe when engaged in a commercial enterprise, the tribe must first adopt an Employment Rights Code with specified components.

The bill exempts funding to tribes under the RHT program from this requirement.

Under the RHT program, created under 2025 federal legislation (P.L.

119-21, § 71401), the Centers for Medicare and Medicaid Services is giving all states grants to implement measures intended to expand rural health care access and quality.

Connecticut is receiving a first-year grant of $154 million under the program.

The Department of Social Services willserveastheleadagencyunderthegrantfunding,collaboratingwith several other agencies (including DPH) to implement projects across four initiatives:

population health outcomes, workforce, data and technology, and care transformation and stability.

§ 6 — EMS COMPACT The bill enters Connecticut into the Recognition of Emergency Medical Services Personnel Licensure Interstate Compact (EMS sSB93 / File No.

44 34 sSB93 File No.

44 compact), but no earlier than one year after Massachusetts, New York, or Rhode Island enters it.

(There are currently 25 member states to the compact;

our neighboring states have not yet joined.) The compact creates a process authorizing EMS personnel who are licensed in one member state to practice across state boundaries without requiring licensure ineachstate.

Member statesmust grant theprivilege to practice to EMS personnel who hold a valid, unencumbered license (or other authorization) in another member state and who otherwise meet the compact’s eligibility requirements.

Generally, by joining the compact, Connecticut retains broad authority to license and regulate EMS personnel, but must grant qualifying EMS providers a privilege to practice in Connecticut.

The compact applies to emergency medical technicians (EMTs), advanced EMTs (AEMTs), paramedics, or other EMS providers at a level between EMT and paramedic.

The compact is administered by the Interstate Commission for EMS Personnel Practice, which Connecticut joins under the bill once it enters the compact.

Among various other provisions, the compact:

1.

sets eligibility criteria for states to join the compact and for EMS personnel to practice under it;

2.

addresses several matters related to disciplinary actions for EMS personnel practicing under the compact, such as information sharing among member states and removal of the privilege to practice;

3.

allows the commission to levy an annual assessment on member states or impose fees on other parties to cover its operational costs;

4.

only allows amendments to the compact to take effect if all member states adopt them into law;

and 5.

has a process for states to withdraw from the compact.

sSB93 / File No.

44 35 sSB93 File No.

44 A broad overview of the compact appears below.

Compact Overview The compact creates a process authorizing EMS personnel to work in multiple states if they are licensed in one member state.

A “license” is a state’s authorization for someone to practice as an EMT, AEMT, paramedic, or level between EMT or paramedic.

(In Connecticut, paramedics are licensed, while EMTs and AEMTs are certified, but all of these would constitute a “license” under the compact’s definition.) Under the compact, a “state” is a U.S.

state, commonwealth, district, or territory.

A “member state” is a state that has enacted the compact.

A “home state” is the member state where someone is licensed to practice emergency medical services.

A “remote state” is a member state where someone is not licensed.

“Privilege to practice” is someone’s authorization to deliver emergency medical services in remote states as authorized under the compact.

Home State Licensure (§ 6(3)) Under the compact, any member state in which someone holds a current license is a home state for the compact’s purposes.

A home state license authorizes someone to practice in a remote state under the privilege to practice only if the home state:

1.

requires the use of the National Registry of Emergency Medical Technicians (NREMT) examination as a condition of issuing initial EMT and paramedic licenses;

2.

has a mechanism to receive and investigate complaints about individuals;

3.

notifies the commission about any adverse action (e.g., disciplinary action against a license or a criminal conviction) or significant investigatory information (e.g., information that the individual represents an immediate threat to public health and sSB93 / File No.

44 36 sSB93 File No.

44 safety) about an individual;

4.

requires a criminal background check for initial licensure applicants, including fingerprints or other biometric-based information that meets FBI requirements (except for federal employees with a suitability determination under federal regulations);

and 5.

complies with the commission’s rules.

A member state may require someone to get licensed in order to practice in that state under circumstances not authorized by the compact’s privilege to practice.

Compact Privilege to Practice (§ 6(4)) The compact requires member states to recognize the privilege to practice of someone licensed in another member state that complies with the above requirements.

To exercise the privilege to practice under the compact, an individual must:

1.

be at least age 18;

2.

have a current unrestricted license (see above) in a member state as an EMT, AEMT, paramedic, or level between EMT and paramedic;

and 3.

practice under the supervision of a medical director (a physician licensed in a member state who is accountable for EMS personnel’s care delivery).

Under the compact, someone providing patient care in a remote state under the privilege to practice must function within the home state’s scope of practice unless and until it is modified by an appropriate authority intheremotestate.

Otherwise, someonepracticing inaremote state is subject to the remote state’s authority and rules.

Conditions of Practice in a Remote State (§ 6(5)) Under the compact, an individual may practice in a remote state sSB93 / File No.

44 37 sSB93 File No.

44 under a privilege to practice only in performing their EMS duties as assigned by an appropriate authority, and when the individual:

1.

originates a patient transport in a home state and transports the patient to a remote state;

2.

originates in the home state and enters a remote state to pick up a patient and provide care and transport to the home state;

3.

enters a remote state to provide patient care or transport within that state;

4.

enters a remote state to pick up a patient and provide care and transport to a third member state;

or 5.

complies with other conditions as determined by the commission’s rules.

Relationship to Emergency Management Assistance Compact (§ 6(6)) Under the compact, if a member state’s governor declares a state of emergency or disaster that activates the Emergency Management Assistance Compact (EMAC), the EMAC compact prevails over any conflicting provisions of this compact as to anyone practicing in a remote state under the governor’s declaration.

(All states are part of EMAC, under which states may provide personnel, equipment, and other supplies to assist other states in governor-declared emergencies.) Veterans, Service Members Separating From Active-Duty Military, and Their Spouses (§ 6(7)) Under the compact, member states must consider someone as satisfying the minimum training and examination requirements for a given EMS license if the person (1) is a veteran, active military service member, member of the National Guard and Reserve separating from an active-duty tour, or the spouse of such a person and (2) holds an unrestricted NREMT certification at or about the level of the license being sought.

Member states must expedite the processing of their licensure applications.

These individuals practicing under the compact sSB93 / File No.

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44 remain subject to the compact’s adverse action provisions (§ 6(8)).

Respective States’ Authority and Adverse Actions (§ 6(4), (8) & (9)) The compact addresses several matters related to states’ authority to investigate and discipline EMS personnel practicing under its procedures.

Broadly, the compact maintains the home state’s authority to regulate the home state license, while authorizing remote states to regulate the compact privilege to practice in their states.

For investigations and adverse actions, a home state’s EMS authority must give the same priority to conduct reported from remote states as it would to conduct within the home state.

The following are examples of the regulatory structure under the compact:

1.

a home state has exclusive authority to impose adverse action against a home state license, but a remote state may take adverse action against an individual’s privilege to practice in that state or take other actions needed to protect its citizens;

2.

if someone’s (a) home state license is restricted or suspended or (b) privilege to practice in any remote state is restricted, suspended, or revoked, he or she cannot practice in any remote state until the license or privilege is restored;

3.

member states must report adverse actions and compact privilege restrictions, suspensions, or revocations to the commission;

4.

memberstatesmayallowsomeonetoparticipateinanalternative program for substance abuse recovery rather than imposing an adverse action, but the person must not practice in any other member state during that time without its prior authorization;

5.

member states’ EMS authorities may issue subpoenas to compel someone’s testimony or the production of evidence (to be enforced as applicable by a remote state’s courts), with the sSB93 / File No.

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and 6.

member states may issue cease and desist orders to restrict, suspend, or revoke someone’s privilege to practice in the state.

Compact Commission (§ 6(10) & (12)) The compact is administered by the Interstate Commission for EMS Personnel Practice, which consists of one voting delegate from each state.

The delegate must be the responsible official of the state’s EMS authority or the official’s designee.

The compact sets several powers, duties, and procedures for the commission.

For example, the commission:

1.

may make rules, binding on member states, to coordinate the compact’s implementation and administration (a rule has no effect if a majority of the member states’ legislatures reject it);

2.

may levy and collect an annual assessment from each member state or impose fees onother parties to cover its operational costs;

and 3.

must have its receipts and disbursements audited yearly and the audit report included in the commission’s annual report.

The compact addresses several other matters regarding the commission and its operations, such as setting conditions under which its members, officers, and employees are immune from civil liability.

Coordinated Database (§ 6(11)) Member states must submit specified information (e.g., on licensure and disciplinary actions) about individuals covered by the compact for inclusion in a database the compact creates.

The database administrator must promptly notify all member states about any adverse action against, or significant investigatory information on, someone in a member state.

Member states that contribute information to the database may designate information that may not be shared publicly without the sSB93 / File No.

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If a member state’s law requires information to be expunged, it must be removed from the database.

Compact Oversight, Dispute Resolution, Enforcement, Member Withdrawal, and Related Matters (§ 6(13)-(15)) Among other related provisions, the compact:

1.

requires each member state’s executive, legislative, and judicial branchesto enforce the compact and take necessary stepsto carry out its purposes;

2.

requires the commission to take specified steps if a member state defaults on its obligations under the compact, and after all other means of securing compliance have been exhausted, allows a defaulting state to be terminated from the compact upon a majority vote of the member states;

3.

requires the commission, upon a member state’s request, to attempt to resolve a compact-related dispute among member states or between member and non-member states;

4.

requires the commission to enforce the compact and rules and allows it to bring legal action against a member state in default upon a majority vote (the case may be brought in the U.S.

District Court for the District of Columbia or the federal district where the commission’s principal offices are located);

5.

allows a member state to withdraw from the compact by repealing the enabling legislation, but withdrawal does not take effect until six months after the repealing statute’s enactment;

6.

allows member states to amend the compact, but no amendment takes effect until all member states enact it into law;

7.

requires the compact to be liberally construed to carry out its purposes, and if the compact is held to violate a member state’s constitution, it remains in effect in the remaining member states;

and sSB93 / File No.

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specifies that the compact does not supersede state law or rules on EMS agency licensure.

§ 7 — BACKGROUND CHECKS FOR EMS CREDENTIALING Under the bill, the DPH commissioner must require anyone applying for EMS professional licensure or certification to submit to a state and national fingerprint-based criminal history records check.

This applies starting oneyear afterMassachusetts,NewYork,orRhodeIslandenacts the EMS compact (i.e.

when Connecticut can enter the compact under the bill).

COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 30 Nay 0 (03/02/2026) sSB93 / File No.

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