Certified peers are considered mental health / addiction recovery professionals in the state of Connecticut. They are held to professional standards and demonstrate their value at every point of a persons recovery journey. Trained peers can work in environments ranging from mental health treatment centers to hospital emergency rooms. In 2017 a question was raised, should insurance companies cover the cost of services provided by these peers? This led to the creation of several bills brought before the state legislature. This page will serve as a reference starting from the first proposed bill in 2017 and all bills that could effect peers in the workforce in the future.
Peer Reimbursement
HB-6887: AN ACT CONCERNING MENTAL HEALTH CARE SERVICES AND SUBSTANCE ABUSE
SERVICES PROVIDED BY CERTIFIED PEER COUNSELORS.
Statement of Purpose: To require that certain health insurance policies cover nonmedical mental health care and substance abuse services provided by certified peer counselors.
Introducer(s):
Insurance and Real Estate Committee
01-25-2017 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
02-02-2017 RESERVED FOR SUBJECT MATTER PUBLIC HEARING
02-09-2017 PUBLIC HEARING 02/16
02-23-2017 VOTE TO DRAFT
03-03-2017 DRAFTED BY COMMITTEE
03-06-2017 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
03-15-2017 JOINT FAVORABLE SUBSTITUTE CHANGE OF REFERENCE Public Health Committee
03-16-2017 FILED WITH LEGISLATIVE COMMISSIONERS’ OFFICE
03-21-2017 REPORTED OUT OF LEGISLATIVE COMMISSIONERS’ OFFICE
03-21-2017 FAVORABLE CHANGE OF REFERENCE, HOUSE TO COMMITTEE ON Public Health
Committee
03-22-2017 FAVORABLE CHANGE OF REFERENCE, SENATE TO COMMITTEE ON Public Health
Committee
Co-sponsor(s):
Rep. Cristin McCarthy Vahey, 133rd Dist. Rep. Dorinda Borer, 115th Dist
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. (NEW) (Effective January 1, 2018) (a) For the purposes of this section: (1) “Certified peer counselor” means an individual certified by the Insurance Commissioner to provide peer support services; and (2) “peer support services” means such nonmedical mental health care services and substance abuse services, as designated by the commissioner, that a certified peer counselor may provide to a person insured under a policy of the type specified in subsection (b) of this section.
(b) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, amended, renewed or continued in this state shall provide coverage for peer support services provided by a certified peer counselor.
(c) The Insurance Commissioner shall adopt regulations, in accordance with chapter 54 of the general statutes, to implement the purposes of this section, including, but not limited to, regulations concerning the: (1) Education and certification of certified peer counselors; (2) peer support services a certified peer counselor may provide; (3) peer support services eligible for reimbursement under subsection (b) of this section; and (4) method and amount of such reimbursement.
Sec. 2. (NEW) (Effective January 1, 2018) (a) For the purposes of this section: (1) “Certified peer counselor” means an individual certified by the Insurance Commissioner to provide peer support services; and (2) “peer support services” means such nonmedical mental health care services and substance abuse services, as designated by the commissioner, that a certified peer counselor may provide to a person insured under a policy of the type specified in subsection (b) of this section.
(b) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes delivered, issued for delivery, amended, renewed or continued in this state shall provide coverage for peer support services provided by a certified peer counselor.
(c) The Insurance Commissioner shall adopt regulations, in accordance with chapter 54 of the general statutes, to implement the purposes of this section, including, but not limited to, regulations concerning the: (1) Education and certification of certified peer counselors; (2) peer support services a certified peer counselor may provide; (3) peer support services eligible for reimbursement under subsection (b) of this section; and (4) method and amount of such reimbursement.
| Bill No.: | HB-6887 |
| Title: | AN ACT CONCERNING MENTAL HEALTH CARE SERVICES AND SUBSTANCE ABUSE SERVICES PROVIDED BY CERTIFIED PEER COUNSELORS. |
| Vote Date: | 3/15/2017 |
| Vote Action: | Joint Favorable Change of Reference to Public Health |
| PH Date: | 2/16/2017 |
| File No.: |
SPONSORS OF BILL:
Insurance and Real Estate Committee
Rep. Cristin McCarthy Vahey, 133rd Dist.
REASONS FOR BILL:
Currently, private insurance coverage does not always cover certified peer counselors and only does so in public insurance through a grant to the Department of Mental Health and Addiction Services. This bill would change that and make it so that private insurance companies need to develop plans that would reimburse peer support specialists and case managers for their work in mental health and substance abuse services.
Substitute Language
Changes the language in the bill from “shall” to “may” under section 2 and section 3 dealing with how the Insurance Commissioner may adopt regulations to implement each respective section regarding individual and group health insurance covering peer support services.
RESPONSE FROM ADMINISTRATION/AGENCY:
State of Connecticut Insurance Department opposed the bill as unnecessary due to existing laws that require carriers to provide medically necessary coverage for mental or nervous conditions. They stated that this coverage includes treatment for mental and nervous conditions which also includes substance use disorder. They also noted the Department’s Consumer Affairs Division is always ready to assist consumers who believe the mental health or substance abuse treatment received was not covered adequately.
Rep. Cristin McCarthy Vahey, 133rd Dist. Supported the bill and testified that individuals accompanied by a team of at least a peer support specialist and a case manager, have a better chance for long term recovery.
NATURE AND SOURCES OF SUPPORT:
Chelsea Boska (McIntosh), Psychiatrist testified that a lot of work she does for her clients involves case management outside of her work sessions and that with this bill, she can refer her clients to a case manager who can then bill for services rendered. She stated that this would free her work schedule in a manner that would allow for more focused care for her clients.
Vered Brandman testified that the bill would allow for peer support services to bill their clients and therefore receive reimbursements from the insurance companies. He also testified that Peer Support Specialists are here to compliment the system and not to take jobs away from other professionals.
Tina M. Corlett supported the bill and stated that this will help individuals navigate the already complex system by granting reimbursements for those who understand the system from firsthand experience.
Marcia DuFore, Executive Director, North Central Regional Mental Health Board
Testified the bill provides reimbursements for peer support counselors and that they have personal experience with the system to help others as they navigate the system. She went on to say that this bill is especially important because DMHAS grant funded services are slated to be cut by $4.7 million by the Governor’s budget proposal. Lastly, she noted that roughly $500,000 was cut last year for peer services.
Dianela Giordana, MSW, Public Policy Director, NAMI Connecticut supported the legislation and noted that there are two certifications for two kinds of peer supports. The first one is an 80 hour certifications through Advocacy Unlimited for those who have experienced mental health matters to become a Recovery Support Specialist. The other one is offered by the CT Community for Addiction Recovery for those who have experienced addiction issues and become certified Recovery Coaches.
Michael Mackniak, Chief Operating Officer, Guardian Ad Litem Services, Inc. testified that by expanding what defines case management and including care coordination as covered services, the quality of life would increase for many throughout the state.
Kati Mapa, Interim Executive Director, Eastern Regional Mental Health Board testified that those with private insurance should have the same access to supports that are available to those with public insurance.
Northwest Regional Health Board, Inc. testified in support of the bill by stating that coverage for peer support specialist are available to those with public coverage under DMHAS funded programs and that those with private insurance should have the same options as well.
Jeanne Proctor supported the bill and noted their son has schizophrenia and the help from peer support specialists and peer groups have been significant in their son’s life.
Marc Rabinowitz testified that peer support services are currently available in every state and Medicaid reimbursable in 35 states. He stated that these services can lead to a decrease in length of hospital stays, reduce symptoms and hospitalizations, and encourage longer-lasting recoveries.
Marisa Rambush, Peer Support Specialist, Milford Division of the CT Strong Grant testified that bill is an important step in addressing mental health and addiction in the state. She went on to say that currently there is no definition of what a peer support specialist is and that with the introduction of insurance companies; a clearer job description and insurance coverage would both work to legitimize the work of a peer support.
Valerie Sacco testified that the cost of insurance to cover these services are less expensive than hospital stays and many other health services.
Michael Scanlon
Susan Buchsbaum
Both submitted similar testimony supported peer support specialists and indicated they wanted to see insurance coverage expanded to cover these costs listed throughout the bill’s language. They stated the peer support specialists are a great community resource and play an important role for those working through recovery.
Elsa Ward, Assistant Director, South Central Peer Services, Continuum of Care, New Haven supported peer support specialists and wanted to see insurance coverage expanded to cover these costs. She stated that she would like to see peer support specialists go through an intensive training program and certification and also that case managers have a Bachelor’s degree.
Margaret Watt, Executive Director, Southwest Regional Mental Health Board, Norwalk
supported peer support specialists and wanted to see insurance coverage expanded to cover these costs. Testified that the cost of insurance to cover these services are less expensive than hospital stays and many other health services. She stated that many people in Connecticut rarely see the benefits from peer support specialists because many insurance companies do not cover the peer support specialists.
Mary Jane Williams Ph.D., RN, Chairperson, Government Relations Committee, Connecticut Nurses Association supported peer support specialists and wanted to see insurance coverage expanded to cover these costs. He also cited a number of statistics that detailed the lack of services available for mental health patients have available in the state. He noted that an avenue to deal with this is to increase the amount of work peer special supports can provide by requiring insurance coverage for their work so they can be reimbursed.
NATURE AND SOURCES OF OPPOSITION:
Greg Benson, Director of Policy, Advocacy Unlimited, Inc.
Paul D. Acker, Director of Recovery University
Both expressed concern over the bill and the language used to define “peer support” and how much latitude it gives to insurance companies to determine what actually counts as “peer support”. He testified that this bill does not protect peer support from co-option and would like to see matters worked out in the bills language before supporting it.
Anthem Blue Cross and Blue Shield in Connecticut expressed concern regarding all bills, this one included, that pertain to health insurance and asked that the committee refrain from passing any legislation until the Congress has acted on the Affordable Care Act in Washington D.C.
Cheri Bragg expressed dissatisfaction with the bill and in particular how it uses the term “case management”. He went on to say that traditional “case management” has not been effective for individuals with mental health and substance abuse for wellness or recovery. He testified that “case management” tends to advocate a dependency on the system and the case managers instead of promoting self-empowerment.
Connecticut Association of Health Plans objected to the bill by how it issues an additional mandate on private insurance companies. They went on to say that this would limit the flexibility an insurance company has in terms of how it constructs benefit packages for consumers.
Michaela I. Fissel
Latosha Taylor
Both testified that by requiring insurance companies, provider networks, and hospital associations to define peer support service, it will become another business transaction. They went on to say that when this becomes purely a business transaction, the effectiveness of this particular support service will be diminished.
Daniel C. Giungi, Senior Legislative Associate, Connecticut Conference of Municipalities (CCM) wanted the committee to hold all proposals until a detailed fiscal analyses was done to see the implications the bill would have on towns and cities as this is an additional mandate on increased insurance coverage.
Natacha Kereljza liked the intent of the bill and peer support services but expressed concern over expanding this service through insurance coverage.
Joanie Masot, Certified Recovery Support Specialist, Advocacy Unlimited Inc. expressed concern over the language in the bill and asked the committee to not permit the peer support’s value to be diminished by allowing the services to become entwined in the insurance infrastructure.
Celeste Mattingly, LCSW testified the training peer support advocacy groups receive cannot compare to what professional counselors have to do in order to become licensed. She stated that this is undervaluing the licensed professional community and urged the committee to oppose the bill.
| Reported by: Stephen Sanabria, Assistant Clerk | Date: March 29, 2017 |
HB-5270: AN ACT CONCERNING PEER SUPPORT SPECIALISTS AND REQUIRING HEALTH INSURANCE COVERAGE FOR OUTPATIENT PEER SUPPORT SERVICES PROVIDED BY CERTIFIED PEER SUPPORT SPECIALISTS.
Statement of Purpose: To require (1) the Commissioner of Public Health to adopt regulations (A) providing for the certification and education of peer support specialists, and (B) specifying the peer support services that a certified peer support specialist may provide to another individual in this state, and (2) health insurance coverage for peer support services provided by certified peer support specialists on an outpatient basis.
Introducer(s):
Insurance and Real Estate Committee
01-14-2019 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
01-31-2019 VOTE TO DRAFT
02-27-2019 DRAFTED BY COMMITTEE
02-28-2019 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
03-01-2019 PUBLIC HEARING 03/05
03-14-2019 JOINT FAVORABLE SUBSTITUTE
03-18-2019 FILED WITH LEGISLATIVE COMMISSIONERS’ OFFICE
03-27-2019 REFERRED TO OFFICE OF LEGISLATIVE RESEARCH AND OFFICE OF FISCAL
ANALYSIS 04/01/19-5:00 PM
04-02-2019 REPORTED OUT OF LEGISLATIVE COMMISSIONERS’ OFFICE
04-02-2019 FAVORABLE REPORT, TABLED FOR THE CALENDAR, HOUSE
04-02-2019 HOUSE CALENDAR NUMBER 176
04-02-2019 FILE NUMBER 270
Co-sponsor(s):
Rep. David Michel, 146th Dist. Rep. Josh Elliott, 88th Dist.
Rep. Cristin McCarthy Vahey, 133rd Dist. Rep. Jeff Currey, 11th Dist.
Rep. Kevin Ryan, 139th Dist. Rep. Peter A. Tercyak, 26th Dist.
AN ACT CONCERNING PEER SUPPORT SPECIALISTS AND
REQUIRING HEALTH INSURANCE COVERAGE FOR OUTPATIENT
PEER SUPPORT SERVICES PROVIDED BY CERTIFIED PEER
SUPPORT SPECIALISTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 Section 1. (NEW) (Effective October 1, 2019) (a) For the purposes of
2 this section:
3 (1) “Certified peer support specialist” means a peer support
4 specialist certified by the Commissioner of Public Health to provide
5 peer support services to another individual in this state;
6 (2) “Peer support services” means all nonmedical mental health care
7 services and substance abuse services provided by peer support
8 specialists; and
9 (3) “Peer support specialist” means an individual providing peer
10 support services to another individual in this state.
11 (b) The Commissioner of Public Health shall adopt regulations, in
12 accordance with chapter 54 of the general statutes, to provide for the
13 certification and education of peer support specialists and specify the
14 peer support services that a certified peer support specialist may
15 provide to another individual in this state.
16 Sec. 2. (NEW) (Effective January 1, 2020) Each individual health
17 insurance policy providing coverage of the type specified in
18 subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general
19 statutes delivered, issued for delivery, amended, renewed or
20 continued in this state shall provide coverage for peer support services
21 provided by certified peer support specialists, as such terms are
22 defined in section 1 of this act, on an outpatient basis. The Insurance
23 Commissioner may adopt regulations, in accordance with chapter 54
24 of the general statutes, to implement the provisions of this section.
25 Sec. 3. (NEW) (Effective January 1, 2020) Each group health insurance
26 policy providing coverage of the type specified in subdivisions (1), (2),
27 (4), (11) and (12) of section 38a-469 of the general statutes delivered,
28 issued for delivery, amended, renewed or continued in this state shall
29 provide coverage for peer support services provided by certified peer
30 support specialists, as such terms are defined in section 1 of this act, on
31 an outpatient basis. The Insurance Commissioner may adopt
32 regulations, in accordance with chapter 54 of the general statutes, to
33 implement the provisions of this section.
Bill No.: HB-5270
Title:
AN ACT CONCERNING PEER SUPPORT SPECIALISTS AND REQUIRING
HEALTH INSURANCE COVERAGE FOR OUTPATIENT PEER SUPPORT
SERVICES PROVIDED BY CERTIFIED PEER SUPPORT SPECIALISTS.
Vote Date: 3/14/2019
Vote Action: Joint Favorable Substitute
PH Date: 3/5/2019
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Insurance and Real Estate Committee
Rep. David Michel, 146th Dist.
Rep. Cristin McCarthy Vahey, 133rd Dist.
Rep. Josh Elliott, 88th Dist.
Rep. Jeff Currey, 11th Dist.
REASONS FOR BILL:
To adopt insurance coverage for outpatient care provided by certified peer support
specialists, while also outlining the licensing procedure to make it legally official.
SUBSTITUTE LANGUAGE:
LCO #5841 which removed Section 1 from the original bill, added the parameters in place of
“peer support services” in Sections 2 & 3, and renamed the sections accordingly. Also,
included the date of enactment in each section.
RESPONSE FROM ADMINISTRATION/AGENCY:
Connecticut Conference of Municipalities testified in opposition, stating “state-mandated
expansions of health insurance coverage would increase insurance costs for towns and
cities.”
Raul Pino, M.D., M.P.H., Commissioner, Department of Public Health wrote testimony in
opposition to the bill because it creates requirements for the department to establish a scope
of services that peer support specialists are to provide, and regulate certification—something
Page 2 of 3 HB-5270
they say many associations already do, and that the Department does not have existing
resources to accomodate. The Department recommends that should the legislation move
forward that there be language outlining parameters for the title of Certified Peer Support
Specialist.
NATURE AND SOURCES OF SUPPORT:
Susan Kelley, Director of Advocacy and Policy, NAMI cited the federal Substance Abuse
and Mental Health Services Administration which recognizes peer support as one of the ten
components to recovery.
Representative David Michel, 146th District wrote in testimony that DMHAS consolidated
mental health and addiction boards into Behavioral Health Boards reinforcing the need to
assure those needing the support get it effectively and at an optimal cost. Also, Rep. Michel
offers a potential language change in line 6 of possibly changing “mental health” to
“behavioral health”, but also sees potential negative consequences of that change.
Suzi Craig, Senior Director of Policy, Mental Health Connecticut supports this bill
because peer support specialists operate well in addition to a therapist or other members of a
treatment plan. She states that the data on these specialists significantly reduce care costs
for patients while lowering hospitalization rates, length of stay, and rehospitalization by
improving care quality and offering health alternatives. “Mental Health CT is the New England
testing site for Mental Health America’s National Certified Peer Specialist certification.”
Thomas Burr, Community and Affiliate Relations Manager, NAMI testified in support
because these specialists provide more real experience and perspective than most clinical
staff.
Susan Kelley, Director of Advocacy and Policy, NAMI cited the federal Substance Abuse
and Mental Health Services Administration which recognizes peer support as one of the ten
components to recovery. She states that reimbursement for peer support should be passed
for insurers, particularly Medicaid, because as of now much of the funding for the services
comes from Department of Mental Health and Addiction services through grants.
Marcia DuFore, North Central Regional Mental Health Board testified in support by
sharing a story of a person close to her who struggled with opioid addiction, and how Marcia
was able to connect her with a solid network of people who were able to help her beat the
addiction. She states that this would not be possible without her or peer support, and that
when hospitalized for addiction, many times you simply wait for release with no guidance of
what is next.
Kathleen Flaherty, Esq., Executive Director, CT Legal Rights Project, INC. testified in
support of this bill because it creates a new type of parity between services provided in the
public and private insurance plans. She states that if both markets were to cover certified
peer support services, availability would be extended to the 80% of the state with private
insurance. Also, she states it provides employment opportunities for people in recovery.
The following people wrote about their support for this bill due to personal experiences which
have lead them to consult with or become a peer support specialist—usually after consulting
Page 3 of 3 HB-5270
clinical care for years and getting a feeling that something was missing—which has aided
both parties immensely in their recovery.
Matthew Reilly wrote that “sometimes traditional care is not enough to feel connected”, and
elaborates on how finding a peer support specialist has helped him in an understanding,
empathetic, non-clinical manner.
David Woodworth
Melissa Thomas
Jeffrey Santo, RSS, RIPPLE
NATURE AND SOURCES OF OPPOSITION:
None Expressed.
Reported by: Logan Cotter Date: 03/28/19
HB-5248: AN ACT ESTABLISHING A TASK FORCE TO STUDY HEALTH INSURANCE COVERAGE FOR PEER SUPPORT SERVICES IN THIS STATE.
Statement of Purpose: To establish a task force to study health insurance coverage for peer support services in this state.
Introducer(s):
Insurance and Real Estate Committee
Bill History:
02-20-2020 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
02-21-2020 PUBLIC HEARING 02/27
03-10-2020 JOINT FAVORABLE
Co-sponsor(s):
Rep. Lucy Dathan, 142nd Dist. Rep. Tom Delnicki, 14th Dist.
Rep. Cristin McCarthy Vahey, 133rd Dist. Rep. Kenneth M Gucker, 138th Dist.
Rep. David Michel, 146th Dist. Rep. Bill Buckbee, 67th Dist.
Rep. Raghib Allie-Brennan, 2nd Dist. Rep. Jillian Gilchrest, 18th Dist.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 Section 1. (Effective from passage) (a) There is established a task force
2 to study health insurance coverage for peer support services in this
3 state. Such study shall include, but need not be limited to, an
4 examination of any means available to increase health insurance
5 coverage for peer support services in this state.
6 (b) The task force shall consist of the following members:
7 (1) Two appointed by the speaker of the House of Representatives;
8 (2) Two appointed by the president pro tempore of the Senate;
9 (3) One appointed by the majority leader of the House of
10 Representatives;
11 (4) One appointed by the majority leader of the Senate;
12 (5) One appointed by the minority leader of the House of
13 Representatives;
14 (6) One appointed by the minority leader of the Senate;
15 (7) The Insurance Commissioner, or the commissioner’s designee;
16 and
17 (8) Two persons appointed by the Governor.
18 (c) Any member of the task force appointed under subdivision (1),
19 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
20 of the General Assembly.
21 (d) All initial appointments to the task force shall be made not later
22 than thirty days after the effective date of this section. Any vacancy shall
23 be filled by the appointing authority.
24 (e) The speaker of the House of Representatives and the president pro
25 tempore of the Senate shall select the chairpersons of the task force from
26 among the members of the task force. Such chairpersons shall schedule
27 the first meeting of the task force, which shall be held not later than sixty
28 days after the effective date of this section.
29 (f) The administrative staff of the joint standing committee of the
30 General Assembly having cognizance of matters relating to insurance
31 shall serve as administrative staff of the task force.
32 (g) Not later than January 1, 2021, the task force shall submit a report
33 on its findings and recommendations to the joint standing committee of
34 the General Assembly having cognizance of matters relating to
35 insurance, in accordance with the provisions of section 11-4a of the
36 general statutes. The task force shall terminate on the date that it
37 submits such report or January 1, 2021, whichever is later.
Bill No.: HB-5248
Title:
AN ACT ESTABLISHING A TASK FORCE TO STUDY HEALTH INSURANCE
COVERAGE FOR PEER SUPPORT SERVICES IN THIS STATE.
Vote Date: 3/10/2020
Vote Action: Joint Favorable
PH Date: 2/27/2020
File No.:
Disclaimer: The following HOUSE FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Insurance and Real Estate Committee
REASONS FOR BILL:
This bill will establish a task force to study health insurance coverage for peer support services in
this state.
RESPONSE FROM ADMINISTRATION/AGENCY:
None Expressed
NATURE AND SOURCES OF SUPPORT:
Paul Acker, Senior Policy Advisor, Advocacy Unlimited supports the passage of HB5248. We ask that two of the ten seats on the task force be for persons with direct lived
experience providing peer support in mental health and/or addition services and that two
additional seats be offered to Advocacy Unlimited and CCAR (Connecticut Community for
Addiction Recovery) who train people to provide professional peer support. Without the vast
expertise and knowledge of people directly involved in peer support, any task force will fail to
capture the core essence of the profession. As many say in our movement, “Nothing about us
without us.” Peer support professionals must be involved in the design, implementation and
evaluation of such a huge shift in the system, as this directly affects their craft and the people
who choose to utilize their support.
Marcia DuFore, Executive Director, Amplify, Inc this is a topic of great concern to me and
one that our members identify as a top priority in all our needs assessments. But the opiate
epidemic has reached such proportions of late, that is hard for any of us to view the problem
Page 2 of 3 HB-5248
from a distance – a problem that does not touch someone we hold dear. That happened for
me several years ago. She explained in detail the hardship of a close family.
People lose out on recovery every day because they lack support at critical junctures for
treating this illness and moving on toward long term sustained recovery. We lose out because
some of these people die and those who love them suffer immensely. We lose out because
of the economic cost of repeated crisis care and the number of people who don’t find
recovery and become productive citizens. We have a crisis. Please move this bill forward and
help us ensure that insurance coverage for mental health and addiction includes critically
needed peer support services.
Kathy Flaherty, Esq., Executive Director, CT Legal Rights Project, Inc. support HB 5248
and establish a task force to study health insurance coverage for peer support services in this
state. Peer-delivered services promote recovery. I would suggest that the task force also
examine coverage for peer support services under Medicaid. It is very important that the Task
Force include people from the various organizations who have been involved in training peer
providers of support services, including recovery support specialists and recovery coaches,
so my suggestion would be that the committee consider amending the bill to name specific
organizations to be included at the table.
Patricia Rehmer, Senior Vice President, Behavioral Health Network, Hartford
Healthcare We would encourage the committee to expand the charge of the group to look at
coverage under Medicaid and to ensure that peer support specialists are included in this
conversation. Should this bill move forward, we would welcome the opportunity to participate.
According to the U.S. Substance Abuse and Mental Health Services Administration
(SAMHSA), peer support workers are people who have been successful in the recovery
process who help others experiencing similar situations. Through shared understanding,
respect, and mutual empowerment, peer support workers help people become and stay
engaged in the recovery process and reduce the likelihood of relapse. Peer support services
can effectively extend the reach of treatment beyond the clinical setting into the everyday
environment of those seeking a successful, sustained recovery process. Peer support is an
evidence-based practice and is cost effective. HHC uses peer support specialists for a variety
of purposes, including long term follow up after discharge. Our peer support specialists must
complete a rigorous 80-hour course and pass a certification exam. Currently we are not
reimbursed for these services either under Medicaid or commercial insurance in Connecticut.
While these services should be available to more patients, we are concerned that if peer
support specialist services are covered by Medicaid or private insurance, they will be limited
to patients who meet their health plan’s medical necessity standards. Right now, providers
who offer this service may do so in cases where Medicaid or insurance is unlikely to
reimburse. This topic certainly merits further study and discussion and we agree with the task
force.
Ben Shaiken, Manager of Advocacy & Public Policy, CT Community Nonprofit Alliance
supports H.B. 5248, which would establish a task force to study health insurance coverage
for peer support services in Connecticut. Peer Support services are recovery-focused
services provided by specialists who have experience recovering from mental health or
substance abuse conditions. They are a crucial part of behavioral health treatment, and a
growing body of evidence and experience shows that peer support services are effective at
treating mental health conditions and helping people recover from addiction. Connecticut
does not require commercial insurance companies cover peer support services, even though
Page 3 of 3 HB-5248
they have been proven effective to help people recover from mental health and substance
abuse conditions. Connecticut also does now allow peer support services to be billed through
Medicaid, even though many other states do. While this important service should be available
to all Connecticut’s residences, we acknowledge that there are several outstanding issues,
including how to certify Peer Support Specialists, that require more in-depth discussion and
analysis. That is why we support H.B. 5248, which would create a task force to determine the
best course of action.
The following individuals submitted testimony in support of this bill:
Ronald Abell Sally Arbott Anna Assad Annie Atwood Nicole Baier Aleska Bembnista
Rhiannon Benedetto Tammy Binnette Linda Bishop Michele Brabant Jennifer Bradshaw
Juliana Bregler Deborah Brown Colleen Buckle y Jennifer Cederberg Shah Chirayu Aprille
Coutss Sharon Dean Terri -Lynne DeFino Matt DeSimone Emily Dionne Traci Eburg Emily
Elander Melissa Florio Anna Marie Fraioli Allie Franco Donald Franco Heather Franklin
Cynthia Fusco Mihirkumar Gosrani Melissa Grandinetti Michael Grube Morgan Grube
Brianna Herbest DelVina Herbest Thomas Herr Cheryl Hill Julie Hulse Leah Hulse Alyssa
Kassimis Christopher Keller Jennifer Kelley Jennifer Kocenko Lynn Kovack Tracey Kurjiaka
Patrice Lago, RN EMT Sandra Lasher -Pelton Susan Leonard Tiffani Little Strongbow Lone
Eagle Mandi MacDonald Frank Manni Cassandra Marden Scott Martin Mariah Martirano Erin
Mccauley Ann Metzger Rebecca Miller Patrick Mitchell Anthony Morrissey Maddy Morrissey,
Heidi Norcross Michelle Palerno Amy Plude Elizabeth Poller Sachs Randi Hailey Ranson
Cathy Renzulli-Valente Ted Roman Terry Sachs Joy Scozzafava Alison Sherman Makayla
Showalter Melissa Silva Lone Eagle Sonny Melissa Storms Leanne Swanson Pinedo Nadine
Tannous Amanda Tarallo Tyler Ulisse Austin Ulisse Naomi Ulisse Casey Villa Miranda Villa
Sharon Villa Brittany Waldron Danielle Walker Donovan Ward Margaret Watt Lisa Winjum
Patricia Zelno
NATURE AND SOURCES OF OPPOSITION:
None Expressed
Reported by: Diane Kubeck Date: April 14, 2020
HB-5550: AN ACT ESTABLISHING A TASK FORCE CONCERNING PEER SUPPORT SPECIALISTS.
Statement of Purpose: To establish a task force to study the possible certification and education of peer support specialists in this state, the peer support services that would be delivered by such certified peer support specialists and possible health insurance coverage for such services.
Introducer(s):
REP. LUCY DATHAN, 142nd DIST.
Bill History:
01-26-2021 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 That a task force be established to study the possible certification and
2 education of peer support specialists in this state, the peer support
3 services that would be delivered by such certified peer support
4 specialists and possible health insurance coverage for such services.
NOTE: During the 2021 legislative session this bill was merged into HB-6588 which addressed multiple mental health and addiction service topics, at that point HB-5550 was no longer relevant.
HB-6588: AN ACT CONCERNING MENTAL HEALTH CARE AND SUBSTANCE ABUSE SERVICES
Statement of Purpose: To: (1) Provide that no individual or group health insurance policy providing coverage for outpatient prescription drugs shall (A) require a prescribing health care provider to prescribe a supply of a covered outpatient psychotropic drug that is larger than the supply of such drug that such provider deems clinically appropriate, or (B) if a prescribing health care provider deems a ninety-day supply of a covered outpatient psychotropic drug to be clinically inappropriate and prescribes less than a ninety-day supply of such drug, impose a coinsurance, copayment, deductible or other out-of-pocket expense for the prescribed supply of such drug in an amount that exceeds the amount of the coinsurance, copayment, deductible or other out of pocket expense for a ninety-day supply of such drug reduced pro rata in proportion to such prescribed supply of such drug; (2) provide that no mental health care benefits provided under state law, with state funds or to state employees shall require a prescribing health care provider to prescribe a supply of an outpatient psychotropic drug that is larger than the supply of such drug that such provider deems clinically appropriate; (3) establish a task force to study methods available to this state, and health carriers doing business in this state, to encourage health care providers providing mental health services to participate in provider networks; and (4) establish a task force to study health insurance coverage for peer support services.
Introducer(s):
Insurance and Real Estate Committee
03-04-2021 REFERRED TO JOINT COMMITTEE ON Insurance and Real Estate Committee
03-05-2021 PUBLIC HEARING 03/09
03-22-2021 JOINT FAVORABLE
03-23-2021 FILED WITH LEGISLATIVE COMMISSIONERS’ OFFICE
04-01-2021 REFERRED TO OFFICE OF LEGISLATIVE RESEARCH AND OFFICE OF FISCAL
ANALYSIS 04/07/21-5:00 PM
04-08-2021 REPORTED OUT OF LEGISLATIVE COMMISSIONERS’ OFFICE
04-08-2021 FAVORABLE REPORT, TABLED FOR THE CALENDAR, HOUSE
04-08-2021 HOUSE CALENDAR NUMBER 260
04-08-2021 FILE NUMBER 344
05-12-2021 HOUSE ADOPTED HOUSE AMENDMENT SCHEDULE A:LCO-8402
05-12-2021 HOUSE PASSED AS AMENDED BY HOUSE AMENDMENT SCHEDULE A
05-14-2021 FAVORABLE REPORT, TABLED FOR THE CALENDAR, SENATE
05-14-2021 SENATE CALENDAR NUMBER 436
05-14-2021 FILE NUMBER 691
Co-sponsor(s):
Rep. Tammy Nuccio, 53rd Dist. Rep. Holly H. Cheeseman, 37th Dist.
Rep. Tom Delnicki, 14th Dist. Rep. Kenneth M Gucker, 138th Dist.
Rep. Whit Betts, 78th Dist.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
1 Section 1. (NEW) (Effective January 1, 2022) Notwithstanding any
2 provision of the general statutes, no individual health insurance policy
3 providing coverage of the type specified in subdivisions (1), (2), (4), (11),
4 (12) and (16) of section 38a-469 of the general statutes delivered, issued
5 for delivery, renewed, amended or continued in this state on or after
6 January 1, 2022, that provides coverage for outpatient prescription
7 drugs shall: (1) Require a prescribing health care provider to prescribe a
8 supply of a covered outpatient psychotropic drug that is larger than the
9 supply of such drug that such provider deems clinically appropriate; or
10 (2) if a prescribing health care provider deems a ninety-day supply of a
11 covered outpatient psychotropic drug to be clinically inappropriate and
12 prescribes less than a ninety-day supply of such drug, impose a
13 coinsurance, copayment, deductible or other out-of-pocket expense for
14 the prescribed supply of such drug in an amount that exceeds the
15 amount of the coinsurance, copayment, deductible or other out-of
16 pocket expense for a ninety-day supply of such drug reduced pro rata
17 in proportion to such prescribed supply of such drug.
18 Sec. 2. (NEW) (Effective January 1, 2022) Notwithstanding any
19 provision of the general statutes, no group health insurance policy
20 providing coverage of the type specified in subdivisions (1), (2), (4), (11),
21 (12) and (16) of section 38a-469 of the general statutes delivered, issued
22 for delivery, renewed, amended or continued in this state on or after
23 January 1, 2022, that provides coverage for outpatient prescription
24 drugs shall: (1) Require a prescribing health care provider to prescribe a
25 supply of a covered outpatient psychotropic drug that is larger than the
26 supply of such drug that such provider deems clinically appropriate; or
27 (2) if a prescribing health care provider deems a ninety-day supply of a
28 covered outpatient psychotropic drug to be clinically inappropriate and
29 prescribes less than a ninety-day supply of such drug, impose a
30 coinsurance, copayment, deductible or other out-of-pocket expense for
31 the prescribed supply of such drug in an amount that exceeds the
32 amount of the coinsurance, copayment, deductible or other out-of
33 pocket expense for a ninety-day supply of such drug reduced pro rata
34 in proportion to such prescribed supply of such drug.
35 Sec. 3. Section 38a-476b of the general statutes is repealed and the
36 following is substituted in lieu thereof (Effective January 1, 2022):
37 Notwithstanding any provision of the general statutes or the
38 regulations of Connecticut state agencies, no mental health care benefit
39 provided under state law, or with state funds or to state employees may,
40 through the use of a drug formulary, list of covered drugs or any other
41 means: (1) Limit the availability of psychotropic drugs that are the most
42 effective therapeutically indicated pharmaceutical treatment with the
43 least probability of adverse side effects; [or] (2) require utilization of
44 psychotropic drugs that are not the most effective therapeutically
45 indicated pharmaceutical treatment with the least probability of adverse
46 side effects; or (3) require a prescribing health care provider to prescribe
47 a supply of an outpatient psychotropic drug that is larger than the
48 supply of such drug that such provider deems clinically appropriate.
49 Nothing in this section shall be construed to limit the authority of a
50 physician to prescribe a drug that is not the most recent pharmaceutical
51 treatment. Nothing in this section shall be construed to prohibit
52 differential copays among pharmaceutical treatments or to prohibit
53 utilization review.
54 Sec. 4. (Effective from passage) (a) There is established a task force to
55 study methods available to this state, and health carriers doing business
56 in this state, to encourage health care providers providing mental health
57 services to participate in provider networks.
58 (b) The task force shall consist of the following members:
59 (1) Two appointed by the speaker of the House of Representatives;
60 (2) Two appointed by the president pro tempore of the Senate;
61 (3) One appointed by the majority leader of the House of
62 Representatives;
63 (4) One appointed by the majority leader of the Senate;
64 (5) One appointed by the minority leader of the House of
65 Representatives;
66 (6) One appointed by the minority leader of the Senate;
67 (7) The Insurance Commissioner, or the commissioner’s designee;
68 and
69 (8) Two appointed by the Governor.
70 (c) Any member of the task force appointed under subdivision (1),
71 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
72 of the General Assembly.
73 (d) All initial appointments to the task force shall be made not later
74 than thirty days after the effective date of this section. Any vacancy shall
75 be filled by the appointing authority.
76 (e) The speaker of the House of Representatives and the president pro
77 tempore of the Senate shall select the chairpersons of the task force from
78 among the members of the task force. Such chairpersons shall schedule
79 the first meeting of the task force, which shall be held not later than sixty
80 days after the effective date of this section.
81 (f) The administrative staff of the joint standing committee of the
82 General Assembly having cognizance of matters relating to insurance
83 shall serve as administrative staff of the task force.
84 (g) Not later than January 1, 2022, the task force shall submit a report
85 on its findings and recommendations to the joint standing committee of
86 the General Assembly having cognizance of matters relating to
87 insurance, in accordance with the provisions of section 11-4a of the
88 general statutes. The task force shall terminate on the date that it
89 submits such report or January 1, 2022, whichever is later.
90 Sec. 5. (Effective from passage) (a) There is established a task force to
91 study health insurance coverage for peer support services in this state.
92 Such study shall include, but need not be limited to, an examination of
93 any means available to increase health insurance coverage for peer
94 support services provided to individuals in this state.
95 (b) The task force shall consist of the following members:
96 (1) Two appointed by the speaker of the House of Representatives,
97 one of whom is a recovery support specialist and one of whom is a
98 member of the Connecticut Certification Board;
99 (2) Two appointed by the president pro tempore of the Senate, one of
100 whom is a recovery coach and one of whom is a representative of the
101 Connecticut Hospital Association;
102 (3) One appointed by the majority leader of the House of
103 Representatives, who is a representative of a program overseen by the
104 Department of Children and Families;
105 (4) One appointed by the majority leader of the Senate, who is a
106 representative of an organization that trains recovery coaches or
107 recovery support specialists;
108 (5) One appointed by the minority leader of the House of
109 Representatives, who is a supervisor of peers from a provider agency
110 that employs peers;
111 (6) One appointed by the minority leader of the Senate, who is a
112 representative of an organization that provides services to Medicaid
113 beneficiaries;
114 (7) One appointed by the Insurance Commissioner, who is a
115 representative of a health carrier; and
116 (8) Two appointed by the Governor, one of whom is a young adult
117 with experience in various forms of peer support and one of whom has
118 perspective concerning community reentry.
119 (c) Any member of the task force appointed under subdivision (1),
120 (2), (3), (4), (5) or (6) of subsection (b) of this section may be a member
121 of the General Assembly.
122 (d) All initial appointments to the task force shall be made not later
123 than thirty days after the effective date of this section. Any vacancy shall
124 be filled by the appointing authority.
125 (e) The speaker of the House of Representatives and the president pro
126 tempore of the Senate shall select the chairpersons of the task force from
127 among the members of the task force. Such chairpersons shall schedule
128 the first meeting of the task force, which shall be held not later than sixty
129 days after the effective date of this section.
130 (f) The administrative staff of the joint standing committee of the
131 General Assembly having cognizance of matters relating to insurance
132 shall serve as administrative staff of the task force.
133 (g) Not later than December 31, 2021, the task force shall submit a
134 report on its findings and recommendations to the joint standing
135 committee of the General Assembly having cognizance of matters
136 relating to insurance, in accordance with the provisions of section 11-4a
137 of the general statutes. The task force shall terminate on the date that it
138 submits such report or December 31, 2021, whichever is later.
Bill No.: HB-6588
Title:
AN ACT CONCERNING MENTAL HEALTH CARE AND SUBSTANCE ABUSE
SERVICES.
Vote Date: 3/22/2021
Vote Action: Joint Favorable
PH Date: 3/9/2021
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Insurance and Real Estate Committee
REASONS FOR BILL:
The bill seeks to prevent the abuse and misuse, or prescriptive medication practices as 90-day
dispensing has been a harmful practice for consumers. The bill also establishes two tasks force
to understand the role of provider networks and peer support services in Connecticut.
RESPONSE FROM ADMINISTRATION/AGENCY:
None expressed.
NATURE AND SOURCES OF SUPPORT:
Claire Bien, Hamden, CT supports the bill regarding forming a task force on peer support.
Having a support group to openly discuss mental health has had a great impact on her life.
Thomas Burr, Community & Affiliates Relations Manager, NAMI Connecticut supports
the bill. He firmly believes that if his son had peer services in his life his path to recovery
would have been shorter and less expensive to the State of Connecticut. Peer support is an
essential role in a health care team and if CT wants to make that happen it needs to make
Certifies Peer Recovery Specialists reimbursable.
Suzi Craig, Registered Lobbyist, Chief Strategy Officer, Mental Health Connecticut
supports the bill as peer support is an essential role on health care teams to support the
recovery process.
Page 2 of 3 HB-6588
Carol Cruz, Milford, CT supports the bill as peer support is an essential role on health care
teams to support the recovery process.
Connecticut Hospital Association supports the establishment of a task force to study
health insurance coverage for peer support services. The bill provides for the appointment of
a representative of CHA to serve on the task force and they welcome the opportunity to
engage in this work as drug overdose continues to endanger the lives of many citizens.
Marcia DuFore, Amplify Inc. supports the bill as peer support is an essential role on health
care teams to support the recovery process. In an experience with a close friend she explains
the lack of resources and support there was and how lives are lost without it.
Hilary Felton-Reid, Connecticut Association of Health Plans offered comments on the
bill. CTAHP supports efforts to minimize and prevent medication misuse and abuse however
each patient responds to treatment differently. Prescriptive treatment and coverage
requirements laid out in statute impeded the ability of carriers and clinicians to adapt
treatment protocols in line with clinical appropriateness. Urged caution in adopting a one-size
fits all policy. With costs of pharmaceuticals rising, it is irresponsible and not in the interest of
the consumer to prohibit the ability of carriers to manage cost. Lastly should the legislature
choose to move forward with the task’s forces, CTAHP request a seat at the table.
Michaela L. Fissel, Executive Director, Advocacy Unlimited supports the bill and offered
some suggestions. She asked for a seat for Advocacy Unlimited and one for the Connecticut
Community for Addiction Recovery. These organizations have had the longest standing
experience with training and educating peer specialists. She also asked for an additional seat
for a person who is working in peer services as a Certified Peer Recovery Specialist and to
replace the representative of the Department of Children and Families with a representative
of the Department of Mental Health and Addiction Services.
Diane Frost, RSS, MSW, Stamford, CT supports the bill and from her experience as a
mental health professional she acknowledged the importance of the bill.
Robert Goethals, New Haven, CT supports the bill as peer support is an essential role on
health care teams to support the recovery process.
Nicole Hampton, Certified Peer Recovery Specialist, Recovery Coach Professional
supports the bill as establishing a task force would elevate and formalized the discussion at a
state level. If we are to increase pathways to peer workforce Certified Peer Recover
Specialists need to be reimbursable.
Danielle Morgan, MSN, CNS, Family PMHNP, APRN-BC, supports the bill as it provides
support for the prescribing providers’ medical decision making while outweighing the 90-day
convenience of health insurers. The appreciation for the complexity of psychiatric care is lost
with patients when inappropriate 90-day dispensing is encouraged. This can lead to noncompliance, treatment failure, poor outcomes and illness that never reaches remission.
Gisela Pena, Hamden, CT supports the bill from personal experience in her own recovery
process, she has had much success with her Certified Peer Recover coach. She urged that
health insurance be inclusive of certified peer support services.
Page 3 of 3 HB-6588
Theo Pinnow, RSS, Naugatuck, CT supports the bill as peer support services is an
essential role in the mental healthcare system. As a recovery support specialist himself he
has witnessed the importance of the role on the individuals.
Jeffrey Santo, Norwalk, CT supports the bill as it is necessary for the future of CT residents.
It will not only help fill the gaps in current mental health and addiction services but allow for
new ideas and practices to be brought to the table.
Ben Shaiken, Manager of Advocacy & Public Policy, CT Community Nonprofit Alliance
supports the bill as research shows that peer support services are effective at treating mental
health conditions and helping people recover from addiction.
David Watson, Monroe, CT supports the bill as it will be a powerful too and resource for
communities. He recommends that there should be strong representation of the peer support
community on the task force to mitigate any misinformation.
Margaret Watt, Norwalk, CT supports the bill as peer support specialists can bridge the
gaps in mental health in an effective manner. Peer Support specialists are important and
have made a big contribution to individuals’ recovery.
NATURE AND SOURCES OF OPPOSITION:
None Expressed.
Reported by: Christina Cruz Date: 04/05/2021
SB-1: AN ACT EQUALIZING COMPREHENSIVE ACCESS TO MENTAL, BEHAVIORAL AND PHYSICAL HEALTH CARE IN RESPONSE TO THE PANDEMIC.
To equalize comprehensive access to mental, behavioral and physical health care in response to the pandemic.
Introduced by:
Public Health Committee
1/08/2021 Referred to Joint Committee on Public Health
3/10/2021 Drafted by Committee
3/11/2021 Referred to Joint Committee on Public Health
3/12/2021 Public Hearing 03/17
3/26/2021 (PH) Joint Favorable
3/29/2021 (LCO) Filed with Legislative Commissioners’ Office
4/09/2021 (LCO) Referred to Office of Legislative Research and Office of Fiscal Analysis 04/14/21 5:00 PM
4/15/2021 (LCO) File Number 481
4/15/2021 Senate Calendar Number 295
4/15/2021 Favorable Report, Tabled for the Calendar, Senate
4/15/2021 (LCO) Reported Out of Legislative Commissioners’ Office
4/28/2021 Referred by Senate to Committee on Appropriations
5/03/2021 (APP) Joint Favorable
5/04/2021 (LCO) Reported Out of Legislative Commissioners’ Office
5/04/2021 (LCO) Filed with Legislative Commissioners’ Office
5/05/2021 Favorable Report, Tabled for the Calendar, Senate
5/05/2021 No New File by Committee on Appropriations
5/18/2021 Senate Passed as Amended by Senate Amendment Schedule A
5/18/2021 Senate Rejected Senate Amendment Schedule B 8695
5/18/2021 Senate Adopted Senate Amendment Schedule A 8687
5/19/2021 House Calendar Number 516
5/19/2021 Favorable Report, Tabled for the Calendar, House
6/01/2021 In Concurrence
6/01/2021 House Passed as Amended by Senate Amendment Schedule A
6/01/2021 House Rejected House Amendment Schedule B 9677
6/01/2021 House Rejected House Amendment Schedule A 9649
6/01/2021 House Adopted Senate Amendment Schedule A
6/07/2021 (LCO) Public Act 21-35
6/08/2021 Transmitted by Secretary of the State to Governor
6/08/2021 Transmitted to the Secretary of State
6/14/2021 Signed by the Governor
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective from passage) It is hereby declared that
racism constitutes a public health crisis in this state and will continue to
constitute a public health crisis until the goal set forth in subsection (c)
of section 3 of this act is attained.
Sec. 2. (NEW) (Effective from passage) (a) There is established a
Commission on Racial Equity in Public Health, to document and make
recommendations to decrease the effect of racism on public health. The
commission shall be part of the Legislative Department.
(b) The commission shall consist of the following members:
(1) Two appointed by the speaker of the House of Representatives,
one of whom shall be a representative of a nonprofit organization that
focuses on racial equity issues and one of whom shall be a representative
of Health Equity Solutions;
(2) Two appointed by the president pro tempore of the Senate, one of
whom shall be a representative of a violence intervention program using
Substitute Senate Bill No. 1
Public Act No. 21-35 2 of 28
a health-based approach to examine individuals post-incarceration and
policies for integration and one of whom shall be a representative of the
Connecticut Health Foundation;
(3) One appointed by the majority leader of the House of
Representatives, who shall be a representative of the Katal Center for
Equity, Health, and Justice;
(4) One appointed by the majority leader of the Senate, who shall be
a representative of the Connecticut Children’s Office for Community
Child Health;
(5) Two appointed by the minority leader of the House of
Representatives, one of whom shall be a physician educator associated
with The University of Connecticut who has experience and expertise in
infant and maternal care and who has worked on diversity and
inclusion policy and one of whom shall be a representative of the
Partnership for Strong Communities;
(6) Two appointed by the minority leader of the Senate, one of whom
shall be a medical professional with expertise in mental health and one
of whom is a representative of the Open Communities Alliance;
(7) The chairpersons of the joint standing committee of the General
Assembly having cognizance of matters relating to public health;
(8) Two members of the Black and Puerto Rican Caucus, appointed
by the caucus chairperson;
(9) One appointed by the Governor, who shall be a representative of
the Diversity, Equity, and Inclusion Committee of the Connecticut Bar
Association;
(10) The Commissioner of Public Health, or the commissioner’s
designee;
Substitute Senate Bill No. 1
Public Act No. 21-35 3 of 28
(11) The Commissioner of Children and Families, or the
commissioner’s designee;
(12) The Commissioner of Early Childhood, or the commissioner’s
designee;
(13) The Commissioner of Social Services, or the commissioner’s
designee;
(14) The Commissioner of Economic and Community Development,
or the commissioner’s designee;
(15) The Commissioner of Education, or the commissioner’s designee;
(16) The Commissioner of Housing, or the commissioner’s designee;
(17) The chief executive officer of the Connecticut Health Insurance
Exchange, or the chief executive officer’s designee;
(18) The executive director of the Commission on Women, Children,
Seniors, Equity and Opportunity, or the executive director’s designee;
(19) The executive director of the Office of Health Strategy, or the
executive director’s designee;
(20) The Secretary of the Office of Policy and Management, or the
secretary’s designee;
(21) The Commissioner of Energy and Environmental Protection, or
the commissioner’s designee; and
(22) The Commissioner of Correction, or the commissioner’s
designee.
(c) Any member of the commission appointed under subdivisions (1)
to (8), inclusive, of subsection (b) of this section may be a member of the
General Assembly. All initial appointments to the commission made
Substitute Senate Bill No. 1
Public Act No. 21-35 4 of 28
under subdivisions (1) to (9), inclusive, of subsection (b) of this section
shall be made not later than sixty days after the effective date of this
section. Appointed members shall serve a term that is coterminous with
the appointing official and may serve more than one term.
(d) The Secretary of the Office of Policy and Management, or the
secretary’s designee, and the representative appointed under
subdivision (1) of subsection (b) of this section as a representative of
Health Equity Solutions, shall serve as chairpersons of the commission.
Such chairpersons shall schedule the first meeting of the commission,
which shall be held not later than sixty days after the effective date of
this section. If appointments under subsection (b) of this section are not
made within such sixty-day period, the chairpersons may designate
individuals with the required qualifications stated for the applicable
appointment to serve on the commission until appointments are made
pursuant to subsection (b) of this section.
(e) Members shall continue to serve until their successors are
appointed. Any vacancy shall be filled by the appointing authority. Any
vacancy occurring other than by expiration of term shall be filled for the
balance of the unexpired term.
(f) A majority of the membership shall constitute a quorum for the
transaction of any business and any decision shall be by a majority vote
of those present at a meeting, except the commission may establish such
committees, subcommittees or other entities as it deems necessary to
further the purposes of the commission. The commission may adopt
rules of procedure.
(g) The members of the commission shall serve without
compensation, but shall, within the limits of available funds, be
reimbursed for expenses necessarily incurred in the performance of
their duties.
Substitute Senate Bill No. 1
Public Act No. 21-35 5 of 28
(h) The commission, by majority vote, shall hire an executive director
to serve as administrative staff of the commission, who shall serve at the
pleasure of the commission. The commission may request the assistance
of the Joint Committee on Legislative Management in hiring the
executive director. The executive director may hire not more than two
executive assistants to assist in carrying out the duties of the
commission.
(i) The commission shall have the following powers and duties: To
(1) support collaboration by bringing together partners from many
different sectors to recognize the links between health and other issues
and policy areas and build new partnerships to promote health and
equity and increase government efficiency; (2) create a comprehensive
strategic plan to eliminate health disparities and inequities across
sectors, in accordance with section 3 of this act; (3) study the impact that
the public health crisis of racism has on vulnerable populations within
diverse groups of the state population, including on the basis of race,
ethnicity, sexual orientation, gender identity and disability, including,
but not limited to, Black American descendants of slavery; (4) obtain
from any legislative or executive department, board, commission or
other agency of the state or any organization or other entity such
assistance as necessary and available to carry out the purposes of this
section; (5) accept any gift, donation or bequest for the purpose of
performing the duties described in this section; (6) establish bylaws to
govern its procedures; and (7) perform such other acts as may be
necessary and appropriate to carry out the duties described in this
section, including, but not limited to, the creation of subcommittees.
(j) The commission shall engage with a diverse range of community
members, including people of color who identify as members of diverse
groups of the state population, including on the basis of race, ethnicity,
sexual orientation, gender identity and disability, who experience
inequities in health, to make recommendations to the relevant state
Substitute Senate Bill No. 1
Public Act No. 21-35 6 of 28
agencies or other entities on an ongoing basis concerning the following:
(1) Structural racism in the state’s laws and regulations impacting public
health, where, as used in this subdivision, “structural racism” means a
system that structures opportunity and assigns value in a way that
disproportionally and negatively impacts Black, Indigenous, Latino or
Asian people or other people of color; (2) racial disparities in the state’s
criminal justice system and its impact on the health and well-being of
individuals and families, including overall health outcomes and rates of
depression, suicide, substance use disorder and chronic disease; (3)
racial disparities in access to the resources necessary for healthy living,
including, but not limited to, access to adequate fresh food and physical
activity, public safety and the decrease of pollution in communities; (4)
racial disparities in health outcomes; (5) the impact of zoning
restrictions on the creation of housing disparities and such disparities’
impact on public health; (6) racial disparities in state hiring and
contracting processes; and (7) any suggestions to reduce the impact of
the public health crisis of racism within the vulnerable populations
studied under subdivision (3) of subsection (i) of this section.
(k) Not later than January 1, 2022, and every six months thereafter,
the commission shall submit a report to the Secretary of the Office of
Policy and Management and the joint standing committees of the
General Assembly having cognizance of matters relating to public
health and appropriations and the budgets of state agencies, in
accordance with the provisions of section 11-4a of the general statutes,
concerning (1) the activities of the commission during the prior sixmonth period;
(2) any progress made in attaining the goal described in
subsection (c) of section 3 of this act; (3) any recommended changes to
such goal based on the research conducted by the commission, any
disparity study performed by any state agency or entity, or any
community input received; (4) the status of the comprehensive strategic
plan required under section 3 of this act; and (5) any recommendations
for policy changes or amendments to state law.
Substitute Senate Bill No. 1
Public Act No. 21-35 7 of 28
Sec. 3. (NEW) (Effective from passage) (a) The Commission on Racial
Equity in Public Health, established under section 2 of this act, shall
develop and periodically update a comprehensive strategic plan to
eliminate health disparities and inequities across sectors, including
consideration of the following: Air and water quality, natural resources
and agricultural land, affordable housing, infrastructure systems, public
health, access to quality health care, social services, sustainable
communities and the impact of climate change.
(b) Such plan shall address the incorporation of health and equity into
specific policies, programs and government decision-making processes
including, but not limited to, the following: (1) Disparities in laws and
regulations impacting public health; (2) disparities in the criminal justice
system; (3) disparities in access to resources, including, but not limited
to, healthy food, safe housing, public safety and environments free of
excess pollution; and (4) disparities in access to quality health care.
(c) Not later than January 1, 2022, as part of such plan, the
commission shall determine, using available scientifically based
measurements, the percentages of disparity in the state based on race,
in the following areas: (1) Education indicators, including kindergarten
readiness, third grade reading proficiency, scores on the mastery
examination, administered pursuant to section 10-14n of the general
statutes, rates of school-based discipline, high school graduation rates
and retention rates after the first year of study for institutions of higher
education in the state, as defined in section 3-22a of the general statutes;
(2) health care utilization and outcome indicators, including health
insurance coverage rates, pregnancy and infant health outcomes,
emergency room visits and deaths related to conditions associated with
exposure to environmental pollutants, including respiratory ailments,
quality of life, life expectancy, lead poisoning and access to adequate
healthy nutrition and self-reported well-being surveys; (3) criminal
justice indicators, including rates of involvement with the justice
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system; and (4) economic indicators, including rates of poverty, income
and housing insecurity. It shall be the goal of the state to attain at least
a seventy per cent reduction in the racial disparities set forth in
subdivisions (1) to (4), inclusive, of this subsection from the percentage
of disparities determined by the commission on or before January 1,
2022.
(d) Upon completion of the initial comprehensive strategic plan, and
thereafter of any update to such plan, the commission shall submit the
plan to the joint standing committee of the General Assembly having
cognizance of matters relating to public health, in accordance with the
provisions of section 11-4a of the general statutes, and to any other joint
standing committee of the General Assembly having cognizance of
matters relevant to what is contained in such plan, as determined by the
commission.
Sec. 4. (Effective from passage) (a) As used in this section, “structural
racism” means a system that structures opportunity and assigns value
in a way that disproportionally and negatively impacts Black,
Indigenous, Latino or Asian people or other people of color, and “state
agency” has the same meaning as provided in section 1-79 of the general
statutes. The Commission on Racial Equity in Public Health, established
under section 2 of this act, shall determine best practices for state
agencies to (1) evaluate structural racism within their own policies,
practices, and operations, and (2) create and implement a plan, which
includes the establishment of benchmarks for improvement, to
ultimately eliminate any such structural racism within the agency.
(b) Not later than January 1, 2023, the commission shall submit a
report, 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 government administration.
Such report shall include the best practices established by the
commission under this section and a recommendation on any legislation
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to implement such practices within state agencies.
Sec. 5. (Effective from passage) The Commissioner of Public Health shall
study the development and implementation of a recruitment and
retention program for health care workers in the state who are people of
color. Not later than February 1, 2022, the commissioner shall report the
results of such study, 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. Such
report shall include any legislative recommendations to improve the
recruitment and retention of people of color in the health care sector,
including, but not limited to, recommendations for the implementation
of such recruitment and retention program.
Sec. 6. (Effective from passage) The Department of Energy and
Environmental Protection shall perform an assessment of racial equity
within environmental health quality programs administered by said
department. Not later than January 1, 2022, the department shall submit
a report, 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 the environment. Such report
shall include the results of such assessment and any legislative
recommendations to improve racial equity within such programs.
Sec. 7. (Effective from passage) (a) As used in this section, “cultural
humility” means a continuing commitment to (1) self-evaluation and
critique of one’s own worldview with regard to differences in cultural
traditions and belief systems, and (2) awareness of, and active
mitigation of, power imbalances between cultures.
(b) The Office of Higher Education, in collaboration with the Board
of Regents for Higher Education and the Board of Trustees of The
University of Connecticut, shall evaluate the recruitment and retention
of people of color in health care preparation programs offered by the
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constituent units of the state system of higher education and the
inclusion of cultural humility education in such programs. Not later
than January 1, 2022, the office shall submit a report, 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 higher education. Such report shall include the
results of such evaluation and any legislative recommendations to
improve the recruitment and retention of people of color in such
programs and include additional cultural humility education in such
programs.
Sec. 8. Subsection (b) of section 2-128 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective from
passage):
(b) Not later than January first, annually, the executive director of the
commission shall submit a status report, organized by subcommission,
concerning its efforts in promoting the desired results listed in
subdivision (1) of subsection (a) of this section to the joint standing
committee of the General Assembly having cognizance of matters
relating to appropriations and the budgets of state agencies in
accordance with the provisions of section 11-4a. On and after January 1,
2022, such report shall include the status of amendments to the joint
rules of the House of Representatives and the Senate concerning the
preparation of racial and ethnic impact statements pursuant to section
2-24b.
Sec. 9. (Effective from passage) (a) There is established a gun violence
intervention and prevention advisory committee for the purpose of
advising the joint standing committees of the General Assembly having
cognizance of matters relating to public health and human services on
the establishment of a Commission on Gun Violence Intervention and
Prevention to coordinate the funding and implementation of evidencebased,
community-centric programs and strategies to reduce street-level
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gun violence in the state. The committee shall: (1) Consult with
community outreach organizations, victim service providers, victims of
community violence and gun violence, community violence and gun
violence researchers and public safety and law enforcement
representatives regarding strategies to reduce community violence and
gun violence; (2) identify effective, evidence-based community violence
and gun violence reduction strategies; (3) identify strategies to align the
resources of state agencies to reduce community violence and gun
violence; (4) identify state, federal and private funding opportunities for
community violence and gun violence reduction initiatives; and (5)
develop a public health and community engagement strategy for the
Commission on Gun Violence Intervention and Prevention.
(b) The committee shall be composed of the following members:
(1) Two appointed by the speaker of the House of Representatives,
one of whom shall be a representative of the Connecticut Hospital
Association and one of whom shall be a representative of Compass
Youth Collaborative;
(2) Two appointed by the president pro tempore of the Senate, one of
whom shall be a representative of the Connecticut Violence Intervention
Program and one of whom shall be a representative of Regional Youth
Adult Social Action Partnership;
(3) Two appointed by the majority leader of the House of
Representatives, one of whom shall be a representative of Hartford
Communities That Care, Inc. and one of whom shall be a representative
of CT Against Gun Violence;
(4) Two appointed by the majority leader of the Senate, one of whom
shall be a representative of Project Longevity and one of whom shall be
a representative of Saint Francis Hospital and Medical Center;
(5) One appointed by the minority leader of the House of
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Representatives, who shall be a representative of Yale New Haven
Hospital;
(6) One appointed by the minority leader of the Senate, who shall be
a representative of Hartford Hospital;
(7) 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 representative of You Are Not
Alone (YANA);
(8) One appointed by the Senate chairperson of the joint standing
committee of the General Assembly having cognizance of matters
relating to public health, who shall be a representative of Mothers
United Against Violence;
(9) One appointed by the executive director of the Commission on
Women, Children, Seniors, Equity and Opportunity, who shall be a
representative of the Health Alliance for Violence Intervention; and
(10) Two appointed by the Commissioner of Public Health, who shall
be representatives of the Department of Public Health’s Injury and
Violence Surveillance Unit.
(c) All initial appointments to the committee shall be made not later
than thirty days after the effective date of this section. Any vacancy shall
be filled by the appointing authority.
(d) The president pro tempore of the Senate shall select the
chairperson of the committee from among the members of the
committee. Such chairperson shall schedule the first meeting of the
committee, which shall be held not later than sixty days after the
effective date of this section. The committee shall meet not less than
bimonthly.
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(e) The administrative staff of the Commission on Women, Children,
Seniors, Equity and Opportunity shall serve as administrative staff of
the committee.
(f) Not later than January 1, 2022, the committee shall submit a report
on its findings and recommendations to the joint standing committees
of the General Assembly having cognizance of matters relating to public
health and human services, in accordance with the provisions of section
11-4a of the general statutes. The committee shall terminate on the date
that it submits such report or January 1, 2022, whichever is later.
Sec. 10. (Effective from passage) The Department of Public Health shall
conduct a study on the state’s COVID-19 response. Not later than
February 1, 2022, the Commissioner of Public Health shall submit a
preliminary report, 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
regarding the findings of such study. Such report may include the
commissioner’s recommendations for (1) any policy changes and
amendments to the general statutes necessary to improve the state’s
response to future pandemics, including, but not limited to,
recommendations regarding provisions of the general statutes or the
regulations of Connecticut state agencies that should automatically be
waived in the event of an occurrence or imminent threat of an
occurrence of a communicable disease, except a sexually transmitted
disease, or a public health emergency declared by the Governor
pursuant to section 19a-131a of the general statutes in response to an
epidemic or pandemic, and (2) how to improve administration of mass
vaccinations, reporting and utilization of personal protective equipment
supply during a public health emergency, cluster outbreak investigation
and health care facilities’ care for patients. As used in this section,
“COVID-19” means the respiratory disease designated by the World
Health Organization on February 11, 2020, as coronavirus 2019, and any
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related mutation thereof recognized by said organization as a
communicable respiratory disease.
Sec. 11. (NEW) (Effective from passage) (a) On and after January 1, 2022,
any state agency, board or commission that directly, or by contract with
another entity, collects demographic data concerning the ancestry or
ethnic origin, ethnicity, race or primary language of residents of the state
in the context of health care or for the provision or receipt of health care
services or for any public health purpose shall:
(1) Collect such data in a manner that allows for aggregation and
disaggregation of data;
(2) Expand race and ethnicity categories to include subgroup
identities as specified by the Community and Clinical Integration
Program of the Office of Health Strategy and follow the hierarchical
mapping to align with United States Office of Management and Budget
standards;
(3) Provide the option to individuals of selecting one or more ethnic
or racial designations and include an “other” designation with the ability
to write in identities not represented by other codes;
(4) Provide the option to individuals to refuse to identify with any
ethnic or racial designations;
(5) Collect primary language data employing language codes set by
the International Organization for Standardization; and
(6) Ensure, in cases where data concerning an individual’s ethnic
origin, ethnicity or race is reported to any other state agency, board or
commission, that such data is neither tabulated nor reported without all
of the following information: (A) The number or percentage of
individuals who identify with each ethnic or racial designation as their
sole ethnic or racial designation and not in combination with any other
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ethnic or racial designation; (B) the number or percentage of individuals
who identify with each ethnic or racial designation, whether as their sole
ethnic or racial designation or in combination with other ethnic or racial
designations; (C) the number or percentage of individuals who identify
with multiple ethnic or racial designations; and (D) the number or
percentage of individuals who do not identify or refuse to identify with
any ethnic or racial designations.
(b) Each health care provider with an electronic health record system
capable of connecting to and participating in the State-wide Health
Information Exchange as specified in section 17b-59e of the general
statutes shall, collect and include in its electronic health record system
self-reported patient demographic data including, but not limited to,
race, ethnicity, primary language, insurance status and disability status
based upon the implementation plan developed under subsection (c) of
this section. Race and ethnicity data shall adhere to standard categories
as determined in subsection (a) of this section.
(c) Not later than August 1, 2021, the Office of Health Strategy shall
consult with consumer advocates, health equity experts, state agencies
and health care providers, to create an implementation plan for the
changes required by this section.
(d) The Office of Health Strategy shall (1) review (A) demographic
changes in race and ethnicity, as determined by the U.S. Census Bureau,
and (B) health data collected by the state, and (2) reevaluate the standard
race and ethnicity categories from time to time, in consultation with
health care providers, consumers and the joint standing committee of
the General Assembly having cognizance of matters relating to public
health.
Sec. 12. Section 19a-59i of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
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(a) There is established a maternal mortality review committee within
the department to conduct a comprehensive, multidisciplinary review
of maternal deaths for purposes of identifying factors associated with
maternal death and making recommendations to reduce maternal
deaths.
(b) The cochairpersons of the maternal mortality review committee
shall be the Commissioner of Public Health, or the commissioner’s
designee, and a representative designated by the Connecticut State
Medical Society. The cochairpersons shall convene a meeting of the
maternal mortality review committee upon the request of the
Commissioner of Public Health.
(c) The maternal mortality review committee may include, but need
not be limited to, any of the following members, as needed, depending
on the maternal death case being reviewed:
(1) A physician licensed pursuant to chapter 370 who specializes in
obstetrics and gynecology, appointed by the Connecticut State Medical
Society;
(2) A physician licensed pursuant to chapter 370 who is a
pediatrician, appointed by the Connecticut State Medical Society;
(3) A community health worker, appointed by the Commission on
Women, Children, Seniors, Equity and Opportunity;
(4) A nurse-midwife licensed pursuant to chapter 377, appointed by
the Connecticut Nurses Association;
(5) A clinical social worker licensed pursuant to chapter 383b,
appointed by the Connecticut Chapter of the National Association of
Social Workers;
(6) A psychiatrist licensed pursuant to chapter 370, appointed by the
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Connecticut Psychiatric Society;
(7) A psychologist licensed pursuant to chapter 20-136, appointed by
the Connecticut Psychological Association;
(8) The Chief Medical Examiner, or the Chief Medical Examiner’s
designee;
(9) A member of the Connecticut Hospital Association;
(10) A representative of a community or regional program or facility
providing services for persons with psychiatric disabilities or persons
with substance use disorders, appointed by the Commissioner of Public
Health;
(11) A representative of The University of Connecticut-sponsored
health disparities institute; or
(12) Any additional member the cochairpersons determine would be
beneficial to serve as a member of the committee.
(d) Whenever a meeting of the maternal mortality review committee
takes place, the committee shall consult with relevant experts to
evaluate the information and findings obtained from the department
pursuant to section 19a-59h and make recommendations regarding the
prevention of maternal deaths. Not later than ninety days after such
meeting, the committee shall report, to the Commissioner of Public
Health, any recommendations and findings of the committee in a
manner that complies with section 19a-25.
(e) Not later than January 1, 2022, and annually thereafter, the
maternal mortality review committee shall submit a report of
disaggregated data, in accordance with the provisions of section 19a-25,
regarding the information and findings obtained through the
committee’s investigation process to the joint standing committee of the
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General Assembly having cognizance of matters relating to public
health, in accordance with the provisions of section 11-4a. Such report
may include recommendations to reduce or eliminate racial inequities
and other public health concerns regarding maternal mortality and
severe maternal morbidity in the state.
[(e)] (f) All information provided by the department to the maternal
mortality review committee shall be subject to the provisions of section
19a-25.
Sec. 13. Section 19a-490u of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
[On or after October 1, 2015, each] (a) Each hospital, as defined in
section 19a-490, shall [be required to] include training in the symptoms
of dementia as part of such hospital’s regularly provided training to staff
members who provide direct care to patients.
(b) On and after October 1, 2021, each hospital shall include training
in implicit bias as part of such hospital’s regularly provided training to
staff members who provide direct care to women who are pregnant or
in the postpartum period. As used in this subsection, “implicit bias”
means an attitude or internalized stereotype that affects a person’s
perceptions, actions and decisions in an unconscious manner and often
contributes to unequal treatment of a person based on such person’s
race, ethnicity, gender identity, sexual orientation, age, disability or
other characteristic.
Sec. 14. (Effective from passage) The chairpersons of the joint standing
committee of the General Assembly having cognizance of matters
relating to public health shall convene a working group to advance
breast health and breast cancer awareness and promote greater
understanding of the importance of early breast cancer detection in the
state. The working group shall (1) identify organizations that provide
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outreach to individuals, including, but not limited to, young women of
color and high school students, regarding the importance of breast
health and early breast cancer detection; and (2) examine payment
options for early breast cancer detection services available to such
individuals. Not later than February 1, 2022, the working group shall
submit, in accordance with the provisions of section 11-4a of the general
statutes, recommendations to the joint standing committee of the
General Assembly having cognizance of matters relating to public
health, regarding appropriations or legislative proposals that will
improve breast cancer awareness and early detection of breast cancer.
Sec. 15. (Effective from passage) (a) As used in this section, “doula”
means a trained, nonmedical professional who provides physical,
emotional and informational support, virtually or in person, to a
pregnant person before, during and after birth.
(b) The Commissioner of Public Health shall conduct a scope of
practice review pursuant to sections 19a-16d to 19a-16f, inclusive, of the
general statutes to determine whether the Department of Public Health
should establish a state certification process by which a person can be
certified as a doula. The commissioner shall report, in accordance with
the provisions of section 11-4a of the general statutes, the findings of
such committee and any recommendations to the joint standing
committee of the General Assembly having cognizance of matters
relating to public health on or before February 1, 2022.
Sec. 16. (Effective from passage) (a) There is established a working
group to develop recommendations for the strategic expansion of
school-based health center services in the state. The working group shall
consider, but need not be limited to, the following: (1) Specific
geographical regions of the state where additional school-based health
centers may be needed, (2) options to expand or add services at existing
school-based health centers, (3) methods for providing additional
support for school-based health centers to expand telehealth services,
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(4) options for expanding insurance reimbursement for school-based
health centers, and (5) options to expand access to school-based health
centers or expand school-based health center sites, which may include
establishing school-based mental health clinics. As used in this
subsection, “school-based mental health clinic” means a clinic that (A) is
located in or on the grounds of a school facility of a school district or
school board or of an Indian tribe or tribal organization, (B) is organized
through school, community and health provider relationships, (C) is
administered by a sponsoring facility, and (D) provides on-site mental,
emotional or behavioral health services to children and adolescents in
accordance with state and local law, including laws relating to licensure
and certification.
(b) The working group shall consist of the following members:
(1) The Commissioner of Public Health, or the commissioner’s
designee;
(2) The Commissioner of Social Services, or the commissioner’s
designee;
(3) The Commissioner of Children and Families, or the
commissioner’s designee;
(4) The Commissioner of Education, or the commissioner’s designee;
(5) The Insurance Commissioner, or the commissioner’s designee;
(6) The chairpersons of the joint standing committee of the General
Assembly having cognizance of matters relating to public health, or the
chairpersons’ designees;
(7) The ranking members of the joint standing committee of the
General Assembly having cognizance of matters relating to public
health, or the ranking members’ designees;
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(8) The chairpersons of the joint standing committee of the General
Assembly having cognizance of matters relating to appropriations, or
the chairpersons’ designees;
(9) The ranking members of the joint standing committee of the
General Assembly having cognizance of matters relating to
appropriations, or the ranking members’ designees;
(10) Two persons designated by the Connecticut Association of
School Based Health Centers;
(11) One person designated by the Community Health Center
Association of Connecticut;
(12) One person designated by the Connecticut Association of
Healthcare Plans;
(13) One person designated by Connecticut Health Center, Inc.; and
(14) One person who is a children’s mental health service provider,
appointed by the Commissioner of Children and Families.
(c) The cochairpersons of the working group shall be the
Commissioner of Public Health, or the commissioner’s designee, and a
member of the working group appointed pursuant to subdivisions (6)
to (9), inclusive, of subsection (b) of this section, elected by the members
of the working group. The cochairpersons shall schedule the first
meeting of the working group, which shall be held not later than sixty
days after the effective date of this section.
(d) Not later than February 1, 2022, the working group shall submit a
report on its findings and any recommendations for the strategic
expansion of school-based health center services, in accordance with
section 11-4a of the general statutes, to the joint standing committees of
the General Assembly having cognizance of matters relating to public
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health and appropriations. The working group shall terminate on the
date that it submits such report or February 1, 2022, whichever is later.
Sec. 17. (Effective from passage) (a) For the fiscal years ending June 30,
2022, and June 30, 2023, the Department of Mental Health and Addiction
Services shall, within available appropriations, increase access to mobile
crisis services throughout the state by expanding such services’ hours of
operation to include nights and weekends.
(b) The Department of Mental Health and Addiction Services shall
develop a plan to increase access to mobile crisis services throughout
the state by making such services available twenty-four hours per day
and seven days per week. Not later than January 1, 2022, the
Commissioner of Mental Health and Addiction Services shall submit a
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
appropriations, regarding such plan. Such report shall include any
legislative recommendations necessary to implement such plan.
Sec. 18. (Effective from passage) (a) As used in this section:
(1) “Peer support services” means all nonmedical mental health care
services and substance use services provided by peer support
specialists; and
(2) “Peer support specialist” means an individual providing peer
support services to another individual in the state.
(b) There is established a task force to study peer support services and
to encourage health care providers to use such peer support services
when providing care to patients. Such study shall include, but need not
be limited to, an examination of methods available for the delivery and
certification of peer support services and payment mechanisms for such
services.
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(c) The task force shall consist of the following members:
(1) Two appointed by the speaker of the House of Representatives,
one of whom has personal experience with psychiatric or substance use
disorders;
(2) Two appointed by the president pro tempore of the Senate, one of
whom has personal experience with psychiatric or substance use
disorders;
(3) One appointed by the majority leader of the House of
Representatives;
(4) One appointed by the majority leader of the Senate;
(5) One appointed by the minority leader of the House of
Representatives, who has personal experience with psychiatric or
substance use disorders;
(6) One appointed by the minority leader of the Senate, who has
personal experience with psychiatric or substance use disorders;
(7) The Commissioner of Mental Health and Addiction Services, or
the commissioner’s designee; and
(8) Two persons appointed by the Governor, one of whom has
personal experience with psychiatric or substance use disorders.
(d) Any member of the task force appointed under subdivision (1),
(2), (3), (4), (5) or (6) of subsection (c) of this section may be a member of
the General Assembly.
(e) All initial appointments to the task force shall be made not later
than thirty days after the effective date of this section. Any vacancy shall
be filled by the appointing authority.
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(f) The speaker of the House of Representatives and the president pro
tempore of the Senate shall select the chairpersons of the task force from
among the members of the task force. Such chairpersons shall schedule
the first meeting of the task force, which shall be held not later than sixty
days after the effective date of this section.
(g) The administrative staff of the joint standing committee of the
General Assembly having cognizance of matters relating to public
health shall serve as administrative staff of the task force.
(h) Not later than January 1, 2022, the task force shall submit a report
on its findings and recommendations to the joint standing committee of
the General Assembly having cognizance of matters relating to public
health, in accordance with the provisions of section 11-4a of the general
statutes. The task force shall terminate on the date that it submits such
report or January 1, 2022, whichever is later.
Sec. 19. (NEW) (Effective from passage) The Department of Mental
Health and Addiction Services shall develop a mental health toolkit to
help employers in the state address employee mental health needs that
arise as a result of COVID-19. Such toolkit shall (1) identify common
mental health issues that employees experience as a result of COVID-19,
(2) identify symptoms of such mental health issues, and (3) provide
information and other resources regarding actions that employers may
take to help employees address such mental health issues. Not later than
October 1, 2021, the Department of Mental Health and Addiction
Services shall post such mental health toolkit on its Internet web site. As
used in this section, “COVID-19” means the respiratory disease
designated by the World Health Organization on February 11, 2020, as
coronavirus 2019, and any related mutation thereof recognized by said
organization as a communicable respiratory disease.
Sec. 20. Section 19a-200 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2021):
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(a) The mayor of each city, the chief executive officer of each town
and the warden of each borough shall, unless the charter of such city,
town or borough otherwise provides, nominate some person to be
director of health for such city, town or borough. [, which] Such person
shall possess the qualifications specified in subsection (b) of this section.
Upon approval of the Commissioner of Public Health, such nomination
shall be confirmed or rejected by the board of selectmen, if there be such
a board, otherwise by the legislative body of such city or town or by the
burgesses of such borough within thirty days thereafter.
(b) Notwithstanding the charter provisions of any city, town or
borough with respect to the qualifications of the director of health, on
and after October 1, 2010, any person nominated to be a director of
health shall (1) be a licensed physician and hold a degree in public health
from an accredited school, college, university or institution, or (2) hold
a graduate degree in public health from an accredited institution of
higher education. The educational requirements of this section shall not
apply to any director of health nominated or otherwise appointed as
director of health prior to October 1, 2010.
(c) In cities, towns or boroughs with a population of forty thousand
or more for five consecutive years, according to the estimated
population figures authorized pursuant to subsection (b) of section
8-159a, such director of health shall serve in a full-time capacity, except
where a town has designated such director as the chief medical advisor
for its public schools under section 10-205. [, and]
(d) No director shall, [not,] during such director’s term of office, have
any financial interest in or engage in any employment, transaction or
professional activity that is in substantial conflict with the proper
discharge of the duties required of directors of health by the general
statutes or the regulations of Connecticut state agencies or specified by
the appointing authority of the city, town or borough in its written
agreement with such director. A written agreement with such director
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shall be submitted to the Commissioner of Public Health by such
appointing authority upon such director’s appointment or
reappointment.
(e) Such director of health shall have and exercise within the limits of
the city, town or borough for which such director is appointed all
powers necessary for enforcing the general statutes, provisions of the
regulations of Connecticut state agencies relating to the preservation
and improvement of the public health and preventing the spread of
diseases therein.
(f) In case of the absence or inability to act of a city, town or borough
director of health or if a vacancy exists in the office of such director, the
appointing authority of such city, town or borough may, with the
approval of the Commissioner of Public Health, designate in writing a
suitable person to serve as acting director of health during the period of
such absence or inability or vacancy and such person’s start date. [,
provided the] The commissioner may appoint such acting director if the
city, town or borough fails to do so. The person so designated, when
sworn, shall have all the powers and be subject to all the duties of such
director.
(g) In case of vacancy in the office of such director, if such vacancy
exists for [thirty] sixty days, said commissioner may appoint a director
of health for such city, town or borough. The person so designated,
when sworn, shall (1) be considered an employee of the city, town or
borough, and (2) have all the powers and be subject to all the duties of
such director.
(h) In case of the absence or inability to act of a city, town or borough
director of health during a public health emergency declared pursuant
to section 19a-131a, the appointing authority of such city, town or
borough shall, with the approval of the Commissioner of Public Health,
designate in writing a suitable person to serve as acting director of
Substitute Senate Bill No. 1
Public Act No. 21-35 27 of 28
health during the period of such absence or inability or vacancy and
such person’s start date. If the city, town or borough fails to appoint such
acting director of health, or fails to notify the commissioner of such
appointment within thirty days, the commissioner shall appoint an
acting director who meets the qualifications specified in subsection (b)
of this section. The person designated as acting director of health
pursuant to this subsection, when sworn, shall (1) be considered an
employee of the city, town or borough, and (2) have all the powers and
be subject to all the duties of such director.
(i) Said commissioner, may, for cause, remove an officer the
commissioner or any predecessor in said office has appointed, and the
common council of such city, town or the burgesses of such borough
may, respectively, for cause, remove a director whose nomination has
been confirmed by them, provided such removal shall be approved by
said commissioner; and, within two days thereafter, notice in writing of
such action shall be given by the clerk of such city, town or borough, as
the case may be, to said commissioner, who shall, within ten days after
receipt, file with the clerk from whom the notice was received, approval
or disapproval.
(j) Each such director of health shall hold office for the term of four
years from the date of appointment and until a successor is nominated
and confirmed in accordance with this section.
(k) Each director of health shall, annually, at the end of the fiscal year,
[of the city, town or borough, file with the Department of Public Health
a report of the doings as such director for the year preceding] submit a
report to the Department of Public Health detailing the activities of such
director during the preceding fiscal year.
[(b)] (l) On and after July 1, 1988, each city, town and borough shall
provide for the services of a sanitarian licensed under chapter 395 to
work under the direction of the local director of health. Where practical,
Substitute Senate Bill No. 1
Public Act No. 21-35 28 of 28
During the legislative session, HB-5550 was merged into several other mental health-related proposals and became part of HB-6588. It eventually got combined again into SB-1, a much larger bill, where it passed. The problem is that the peer task force seemed lost in the mix, and was pushed back to page 22 of the 28-page document. Among other things, it states:
“Not later than January 1, 2022, the task force shall submit a report on its findings and recommendations to the joint standing committee of the General Assembly having cognizance of matters relating to public health, in accordance with the provisions of section 11-4a of the general statutes.” [sic]
Updated 10-11-2022: As of the addition of this note, nine months past the deadline for the report, the task force has not yet had its first meeting. It died because politicians who were part of the process never finished making all necessary appointments to establish the task force.
