VIEW THE LEGISLATIVE ACCOMPLISHMENTS BROCHURE HERE

It was an exciting and successful 2022 Legislative year! Here are a few wins for CPA in terms of bills that were passed and will go into effect in the very near future: PSYPACT; Telehealth extension; Mental Health Parity enforcement; virtual Continuing Education; and funding for mental health.

CPA’s Lobbyist, Capitol Consulting, tracked and/or lobbied 141 bills that impacted CT psychologists.  Bills of interest to CPA included: expansive children’s mental health legislation to help combat the youth mental health crisis; a data privacy bill to allow customers to be aware when their personal information is being tracked; juvenile justice legislation was passed in response to an uptick in motor vehicle thefts; Connecticut’s clean air act was updated to meet California’s clean air standards aiming to reduce vehicle emissions; and reproductive rights were extended allowing more providers to perform abortions and providing the legal protection of providers and patients from out of state laws.

Find below a summary of the significant legislation of interest:

HB 5001 – AN ACT CONCERNING CHILDREN’S MENTAL HEALTH. This bill aims to improve the availability and provision of mental health, behavioral health and substance use disorder treatment services to children. 
 Allows DCF to work collaboratively with CT DPH to implement waivers on licenses and fees for child behavioral health providers. 

Establishes a 9-8-8 Suicide Prevention and Mental Health Crisis Lifeline. (Effective October 1, 2022) 
Requires certain health insurance policies to cover two mental health wellness examinations per year with no patient cost sharing or prior authorization requirements. (Effective January 1, 2023)

Requires Office of Health Strategy (OHS) to study and report the rates at which insurance companies in the state reimburse healthcare providers for physical, mental, and behavioral health benefits. Requires OHS to study issues related to pay parity for behavioral and mental health and other providers in HUSKY Health and the private insurance market. (Effective Upon Passage)

Requires the Department of Social Services (DSS) to implement a Medicaid reimbursement system to encourage collaboration between
primary care providers and behavioral and mental health providers.
(Effective July 1, 2022)

HB 5500 – AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH’S RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES.

This is the annual bill that makes various changes to the Public Health Statutes as recommended by The Department of Public Health (DPH) and the Public Health Committee. Included in this bill, is a change to psychologists’ continuing education requirement to allow not less than five continuing education units to be earned through synchronous online education. 

SB 2 – AN ACT EXPANDING PRESCHOOL AND MENTAL AND BEHAVIORAL SERVICES FOR CHILDREN.

This bill aims to address the pandemic impact on childhood depression,
anxiety and developmental delays through the expansion of support services. 
This bill enters Connecticut into the Psychology Interjurisdictional Compact (PSYPACT), which provides a process authorizing psychologists to practice by (1) telehealth and (2) temporary in-person, face-to-face services across state boundaries, without requiring psychologist licensure in each state. (Effective October 1, 2022) 

Extends telehealth and insurance coverage requirements for the delivery telehealth services by one year to June 30, 2024.; clarifies that telehealth excludes audio-only telephone for policies that use a provider network and the telehealth provider is out-of-network; and applies the coverage requirements to high deductible health plans to the extent permitted by federal law. Permanently requires insurance policies to cover services provided through telehealth to the same extent that they cover them when provided in person by a Connecticut-licensed provider, rather than by any provider.  Prohibits hospitals from charging a facility fee for telehealth services, whether those services
are provided on or off the hospital campus. (Effective Upon Passage) 
Extends provisions allowing certain out-of-state telehealth providers to provide telehealth services in Connecticut starting July 1, 2024 to June 30, 2024; permanently authorizes certain out-of-state mental and behavioral health service providers to practice telehealth in Connecticut
under certain conditions.

2021 was an incredibly busy legislative year! We are thankful for our incredible lobbying team, who works tirelessly to promote psychology, mental health, and help us use science to inform societal problems and social justice-oriented advocacy and legislation.

Capitol Consulting tracked and/or lobbied over 300 bills that had either an impact or potential impact on the Connecticut Psychological Association (CPA).

More details on legislative happenings, specific bills of interest, and updates can be found in the full report below. This information is provided to you as a benefit of your CPA membership. Your membership is critically important and directly supports all of the work and advocacy that occurs every year. We cannot do this work without you!

Thank you for your membership, support, and partnership in keeping psychology and the issues we care about at the forefront of the legislature and actively moving forward. Together we can keep psychology vibrant, serve and protect our communities, and advance issues of importance to our field and society at large!

Please see the following overview summary from the 2021 Capitol Consulting Legislative Report for CPA:
Capitol Consulting worked with CPA on a variety of issues over the Session and during the pandemic. We managed, along with Dr. Marcy Russo and the CPA Legislative Committee Leadership, all bills and Executive Orders concerning the pandemic, including bills that highlighted the need for providing appropriate mental health treatment for: first line health care personnel and other frontline workers, COVID patients, and all patients suffering from the impact of the pandemic. 

We tracked or lobbied a myriad of issues that were of concern to CPA and its many different issues and divisions. These generally included (some of the critical issues will be discussed in detail below):
• Telehealth permanency;
• Including Connecticut as a state that joins PsyPACT);
• Adult use of cannabis;
• Suicide prevention efforts and mental health awareness;
• Conditions under which to use electroshock therapy;
• Involuntary commitment;
• Gun control;
• Veteran’s services;
• Family court / guardian ad litem changes;
• Peer support services;
• Insurance issues including mental health parity reimbursement, and prompt pay 
proposals;
• Juvenile Justice, including teen auto theft; and
• Social and emotional learning programs in schools.

Going forward, there will be a Special Session in the fall to handle the expenditure policy of the remaining $300 million in federal American Rescue Plan Act (ARPA) funds held back for review by the state. There will also be a Special Session in mid-July to review whether to extend the Governor’s executive authority over the pandemic through at least September 30, if not through the end of the year. While we do not anticipate any actions dramatically affecting CPA during these sessions, we will be keeping Marcy Russo, the Legislative Committee and CPA Leadership involved and informed as usual.

For the full report click here: 2021_Leg_Report_CT_Psychological_Association_FINAL

Compiled by Capitol Consulting

• HB 5233 – AN ACT CONCERNING PAYMENTS TO PROVIDERS OF SOCIAL SERVICES This bill sought to ensure adequate payment to providers of social services to ensure access to quality care and integrate peer support services for behavioral health into the Medicaid program. The bill had two main provisions: (1) to permit non-profit providers of human services to use any surplus in funding to reinvest in client services; and (2) to amend the Medicaid state plan to cover services provided by peer support specialists to clients with substance abuse and/or mental health disorders. The first section is intended to incentivize providers to achieve efficiencies, enabling them to serve a greater number of clients. The second section is intended to assist clients in recovery by providing support from peer mentors who have had successful treatment for similar diagnoses. The bill had a public hearing on February 25th and was voted out of the Human Services Committee on March 5th.
• SB 13 – AN ACT EXPANDING ECONOMIC OPPORTUNITY IN LICENSED OCCUPATIONS This bill was part of the Governor’s budget recommendations. While psychology licensure was not initially included in the bill, the Governor’s Office had suggested that CTPA and Capitol Consulting work with the General Law Committee to make them aware of the national efforts to improve access to mental health care via the Psychology Interjurisdictional Compact (PSYPACT) and to request that Connecticut joins in the national effort by PSYPACT into the bill. The bill had a public hearing on March 5th and was unanimously voted out of the General Law Committee on March 10th. 
• SB 379 – AN ACT PROHIBITING HEALTH CARE INSTITUTIONS FROM REQUIRING COGNITIVE TESTING FOR HEALTH CARE PROVIDERS SOLELY BASED ON AGE This bill sought to prevent health care institutions from requiring cognitive testing of health care providers solely based on the age of the provider. Under existing law and effective October 1, 2015, hospitals and health care providers are required to report information when another health care provider is, or may be, unable to practice his or her profession with reasonable skill and safety. The bill had a public hearing on March 9th.
• SB 442 – AN ACT CONCERNING COURT PROCEEDINGS INVOLVING ALLEGATIONS OF FAMILY VIOLENCE AND DOMESTIC ABUSE This bill sought to enhance court protections afforded to victims of family violence and domestic abuse. The bill includes many provisions, including making domestic violence the first factor assessed by the court in custody cases when determining the best interests of the children. The bill had a public hearing scheduled for March 18th, which did not take place due to the COVID adjournment.
• SB 443 – AN ACT CONCERNING PRETRIAL ALCOHOL AND DRUG EDUCATION PROGRAMS This bill sought to make changes to the pretrial alcohol education program and pretrial drug intervention and community service program to address access issues, standardize education and treatment session numbers, raise fees and address program costs and eliminate stigmatizing language. The bill had a public hearing scheduled for March 20th, which did not take place due to the COVID adjournment. 

Legislation of Interest Monitored in the 2020 Session:

• HB 5019 – AN ACT CONCERNING FAIR FUTURES FOLLOWING ERASURE OF CRIMINAL RECORDS This is one of the Governor’s budget implementation bills and it would have allowed misdemeanors to be erased from an individual’s record after a waiting period instead of being expunged or sealed. The bill had a public hearing on March 9th. In addition to this bill, Capitol Consulting monitored several other bills that pertained to criminal records and court proceedings, including: SB 316 an SB 455.
• HB 5020 – AN ACT IMPLEMENTING THE GOVERNOR’S BUDGET RECOMMENDATIONS REGARDING PUBLIC HEALTH. This bill, which had a public hearing on March 6th, would have implemented the Governor’s recommendation for the Department of Public Health. It is a bill that we annually monitor for CTPA.
• HB 5083 – AN ACT CONCERNING MEDICAID PROVIDER RATES AND ACCESS TO CARE This bill would have required the Commissioner of Social Services to pay Medicaid providers enough to ensure that Medicaid recipients have access to quality care. This bill was proposed by State Representative Jillian Gilchrest, but was never raised by the Human Services Committee.
• HB 5095 – AN ACT ESTABLISHING A TASK FORCE TO STUDY A CONSERVED PERSON’S RIGHT TO INTERACT WITH OTHERS This bill sought to establish a task force to study how best to ensure the rights of a person under conservatorship to interact with others. Such study shall include, but need not be limited to: (1) An examination of whether current state laws provide the least restrictive means to ensure such person may maintain relationships with family members and others, and (2) best practices to resolve conflicts between a conservator of the person, and family members and others regarding access to a person under conservatorship while assuring the safety of such person. The bill had a public hearing on February 18th.
• HB 5145 – AN ACT CONCERNING THE ANNUAL REPORTING OF THE NUMBER OF VERIFIED ACTS OF BULLYING IN SCHOOLS This bill sought to eliminate the requirement that each school under the jurisdiction of a local or regional board of education annually report the number of verified acts of bullying in such school to the Department of Education. The bill had a public hearing on February 18th and the Committee on Children decided to take no further action on the bill on February 27th. In addition to this bill, Capitol Consulting monitored several other bills that pertained to bullying, including: HB 5437 and SB 73.
• HB 5146 – AN ACT ESTABLISHING A YOUTH SUICIDE PREVENTION PILOT PROGRAM This bill would have required the Department of Children and Families and the Office of the Child Advocate to establish a youth suicide prevention pilot program. The pilot program shall provide youth suicide prevention training to: (1) school employees, (2) employees of youth service bureaus, (3) employees of youth-serving organizations, (4) employees of operators of youth athletic activities, or (5) employees of municipal social service agencies. The pilot program shall be administered to not less than 20 employee groups in the state and with respect to school employees may be included as part of an in-service training program. The bill had a public hearing on February 18th and was voted out of the Committee on Children on March 10th. In addition to this bill, Capitol Consulting monitored several other bills that pertained to suicide prevention, including: SB 130, SB 356 and SB 386.
• HB 5217 – AN ACT ESTABLISHING A WORKING GROUP TO STUDY ISSUES RELATING TO SCHOOL START TIMES This bill would have required the Department of Education to establish a working group to study issues relating to school start times. In conducting such study, the working group shall analyze (1) the effect of the starting time of regularly scheduled instruction on child growth and development, (2) whether there is a correlation between school start times and educational outcomes and student productivity, (3) the feasibility of implementing a school start time requirement in the state, and (4) whether any other states have implemented a school start time requirement. The bill had a public hearing on March 6th.
• HB 5248 – AN ACT ESTABLISHING A TASK FORCE TO STUDY HEALTH INSURANCE COVERAGE FOR PEER SUPPORT SERVICES IN THIS STATE This bill would establish a task force to study health insurance coverage for peer support services in the state. Such study shall include, but need not be limited to, an examination of any means available to increase health insurance coverage for peer support services in this state. The bill had a public hearing on February 27th and was voted out of the Insurance and Real Estate Committee on March 10th.
• HB 5254 – AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR MEDICATION- ASSISTED TREATMENT FOR OPIOID USE DISORDER This bill would have required health insurance coverage for medication-assisted treatment of opioid use disorders. The bill had a public hearing on February 27th and was voted out of the Insurance and Real Estate Committee on March 10th.
• HB 5256 – AN ACT CONCERNING REQUIRED HEALTH INSURANCE COVERAGE FOR DETOXIFICATION AND SUBSTANCE ABUSE SERVICES This bill would have modified required health insurance coverage for detoxification and substance abuse services. The bill had a public hearing on February 27th and was voted out of the Insurance and Real Estate Committee on March 10th.
• HB 5306 – AN ACT CONCERNING TEMPORARY STATE SERVICES FOR VICTIMS OF DOMESTIC VIOLENCE This bill would have expedited nutritional assistance, child care benefits and cash assistance for victims of domestic violence. This bill had a public hearing on March 5th. In addition to this bill, Capitol Consulting monitored several other bills that pertained to domestic violence and sexual assault, including: HB 5244, HB 5448, HB 5502, SB 7, SB 19, SB 74, SB 404, and SB 446.
• HB 5307 – AN ACT CONCERNING DEPARTMENT OF SOCIAL SERVICES’ PAYMENT SUSPENSIONS This bill would have given providers of social services due process protections before payment is suspended by the Department of Social Services. The bill had a public hearing on March 5th.
• HB 5309 – AN ACT CONCERNING MEDICAID AUDITS. This bill would eliminate the extrapolation of provider clerical errors in Medicaid audits and limit the recovery by the state, against providers, to any resulting overpayment and state administrative expenses related to the investigation of the clerical error. The bill had a public hearing scheduled for March 17th, which never took place due to the COVID adjournment.
• HB 5332 – AN ACT REQUIRING A STUDY OF THE TIMELINESS OF REPORTS AND FAILURE TO REPORT BY MANDATED REPORTERS This bill sought to require the Department of Children and Families (DCF) to conduct a study of the timeliness of reports and failure to report by mandated reporters. Such study shall include, but need not be limited to, the number of (1) reports received by the department pursuant to each said section from each category of mandated reporter described in section 17a-101 of the general statutes, (2) investigations relating to delayed reporting or failure to report conducted by the department, listed by category of mandated reporter and including for each instance of delayed reporting the amount of time elapsed beyond the relevant time period for reporting, if known, (3) notifications made by the Commissioner of Children and Families to the Chief State’s Attorney pursuant to subsection (c) of section 17a-101a of the general statutes, listed by category of mandated reporter and including for each instance of delayed reporting the amount of time elapsed beyond the relevant time period for reporting, if known, and (4) mandated reporters found guilty under the provisions of subdivisions (1) and (2) of subsection (b) of section 17a-101a of the general statutes, listed by category of mandated reporter. The bill had a public hearing on March 3rd.
• HB 5378 – AN ACT CONCERNING THE INTEGRATION OF SOCIAL-EMOTIONAL LEARNING IN PROGRAMS OF PROFESSIONAL DEVELOPMENT FOR EDUCATORS IN CONNECTICUT This bill would have integrated the principles and practices of social-emotional learning in the program of professional development for educators in the state. The bill had a public hearing on March 9th.
• HB 5417 – AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH’S RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES. This bill, which is introduced annually, would implement the Department of Public Health’s recommendations on revising provisions of the public health statutes. The bill had a public hearing on March 9th.
• HB 5420 – AN ACT CONCERNING AID IN DYING FOR TERMINALLY ILL PATIENTS This bill would have authorized a patient who (1) is an adult, (2) is competent, (3) is a resident of this state, (4) has been determined by such patient’s attending physician to have a terminal illness, and (5) has voluntarily expressed his or her wish to receive aid in dying, may request aid in dying by making two written requests to such patient’s attending physician. The bill had a public hearing scheduled for March 16th, which never took place due to the COVID adjournment.
• HB 5443 – AN ACT CONCERNING A STUDY OF MEDICAID-FUNDED PROGRAMS. This bill sought to require the commissioner of the Department of Social Services (DSS) to study the efficacy of Medicaid-funded programs. Such study shall include, but not be limited to, a report on: factors the commissioner deems pertinent to quality of care; whether there are any gaps in access by eligible residents; and whether any provisions of the program need to change to conform with the requirements of the Patient Protection and Affordable Care Act. The bill was scheduled to have a March 17th public hearing, which never happened due to the COVID adjournment.
• HB 5488 – AN ACT CONCERNING PHYSICIAN ASSISTANTS’ SCOPE OF PRACTICE This bill makes various revisions to the general statutes concerning physician assistants’ scope of practice. The bill would allow PAs the same level of authority as an APRN and physician have currently in a myriad of situations. The bill did not have a public hearing before the Public Health Committee because of the COVID adjournment. The bill was scheduled to have a March 20th public hearing, which never happened due to the COVID adjournment.
• SB 16 – AN ACT CONCERNING THE ADULT USE OF CANNABIS. This was a bill that the Governor proposed as part of his budget recommendations. The bill would have allowed a consumer 21 years of age or older to possess, use and otherwise consume cannabis and cannabis products, provided the amount of all such cannabis, including the amount contained in any cannabis product, does not exceed such consumer’s possession limit of one and one-half ounces of cannabis, of which no more than five grams may be in the form of a cannabis concentrate. The bill had a public hearing on March 2nd. We also tracked a similar bill, SB 6, which sought to legalize and tax the retail sale of marijuana.
• SB 246 – AN ACT CONCERNING VARIOUS REVISIONS TO THE DEPARTMENT OF DEVELOPMENTAL SERVICES STATUTES This bill sought to (1) make information in the Department of Developmental Services’ abuse and neglect registry available to the Department of Administrative Services, (2) allow the Commissioner of Developmental Services or a Department of Developmental Services regional or training school director to consent to emergency medical treatment for an individual under the custody or control of the department, (3) restrict legal representatives of persons with intellectual disabilities from accessing abuse and neglect reports when the legal representative is the alleged perpetrator of such abuse or neglect or is residing with the alleged perpetrator, and (4) encourage licensed residential facilities to adopt standards that promote energy efficiency and incorporate environmentally friendly building materials. The bill had a public hearing on March 6th.
• SB 303 – AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE TASK FORCE REGARDING THE PREVENTION AND TREATMENT OF MENTAL ILLNESS AT INSTITUTIONS OF HIGHER EDUCATION This bill would have implemented the recommendations of the task force regarding the prevention and treatment of mental illness at institutions of higher education. The bill had a public hearing on March 3rd.
• SB 335 – AN ACT CONCERNING THE ROLE OF CLINICAL PEERS IN ADVERSE DETERMINATION AND UTILIZATION REVIEWS This bill sought to (1) Redefine “clinical peer” for the purposes of adverse determination and utilization reviews; and (2) require health carriers to provide certain clinical peers with the authority to reverse initial adverse determinations. The bill had a public hearing on March 5th and was voted out of the Insurance and Real Estate Committee on March 10th.
• SB 388 – AN ACT CONCERNING REVIEW OF ANIMAL CRUELTY LAWS BY THE CONNECTICUT SENTENCING COMMISSION This bill would have required the Connecticut Sentencing Commission to review the animal cruelty laws in this state and other states and make recommendations, if any, to the legislature for changes to state laws. As part of such review, the commission shall examine penalties for animal cruelty imposed by laws of this state and other states and whether there are national or regional trends concerning changes to such penalties. The bill had a public hearing on March 9th. 

Executive Orders of Interest: Capitol Consulting has sent regular updates on all the Executive Orders from Governor Lamont as well as orders from relevant state agencies. Of particular interest to CTPA was the initial Executive Order that confirmed that psychologists were considered essential businesses, the Phase One Reopening Plan scheduled for Wednesday, May 20th, as well as the Phase Two Reopening Plan scheduled for Wednesday, June 17th. Executive Order 7G allowed for existing patients to have access to telehealth and allowed for audio only to be added to telehealth services and Executive Order 7DD allowed for new patients to have access to telehealth, allowed for audio only telehealth, and allowed out- of- state providers to provide telehealth services. We will continue to send these updates as they occur.

Prepared by Anita Schepker, Esq., Josh Hughes, Esq., and Mike Dugan Capitol Consulting LLC June 19, 2019 

The General Assembly adjourned the 2019 legislative session on Wednesday, June 5^th, at midnight, its constitutionally mandated adjournment date. The November election resulted in a state government trifecta, with Democratic Governor Ned Lamont taking the helm proclaiming a fresh approach to governing and no state political experience. Additionally, a record number of Democrats won seats in traditionally Republican-held districts in both the House and the Senate, giving them a handy majority, although neither chamber has veto override capability without the help of the Republicans. The State Senate stands at 22 Democrats to 14 Republicans. The Democrats control the 151-member State House with 91 members to the Republicans 60.

During the last few days of the General Assembly Session, Connecticut legislators approved a two-year, $43 billion state budget. While the budget was approved only by Democrats, there were 5 Democrats in the House and two in the Senate who voted against the package. The 567-page budget will close a projected deficit of $3.7 billion. It increases spending by 1.7 percent in the first year and 3.4 percent in the second year, which are lower spending increase than in past years. The Rainy Day Fund, currently $1.2 billion, could grow to $2.65 billion in the fall.

The budget includes no reduction in state aid to cities and towns. And, the budget contains very few tax increases as compared to previous years—–while not increasing the sales tax rate or changing the income tax, there is an expansion of sales taxes onto certain services previously exempt from the tax such as parking, dry cleaning, laundry and interior design services.

Governor Lamont issued a statement and commented that he was proud of the overall budget, and that it was a fair and balanced document. Yet he also noted that the state still had much more work to do as he alluded to the fact that a Special Session may be necessary. The Republicans countered with a statement that the budget “lacked a long- term, strategic vision to help small businesses, create jobs and kick-start the state’s slow- growth economy”.

The Governor’s comments concerning “more work to do” became quite clear; the day after the session was over, he told the press that he intended to call the General Assembly into Special Session to address the issue of the implementation of tolls in Connecticut, and potentially to review gaming issues in the state. Shortly before the close of the Regular session, the General Assembly also called themselves into Special Session, as they did not have time to vote on bonding or school construction items. It is expected that the Special Sessions will be held in July. Capitol Consulting will keep you informed of all of the activities post-session, including meetings and any Special Sessions that take place.

For CPA, Capitol Consulting tracked and/or lobbied over 100 bills that had either an impact or potential impact on the practice of psychology, psychologists and the people that they serve. It is clear that most legislators have a keen interest in behavioral health issues, but budget constraints and insurance reimbursement issues remain.

Legislation of Interest to CPA which FAILED

• SB 966 AN ACT CONCERNING THE PRESCRIPTIVE AUTHORITY OF PSYCHOLOGISTS: This bill would have allowed licensed psychologists (doctoral-level psychologists) to apply for certification from the Department of Public Health to prescribe, administer and dispense drugs and controlled substances after the completion of a rigorous Master’s degree program in psychopharmacology above and beyond their doctoral degree, including the passage of a nationally certified test and a certain level of supervision under a psychiatrist or M.D. CPA did an outstanding job of getting this bill raised in the Committee for a public hearing and fell short by one vote of getting it out of committee. CPA is putting together a strategy for the Board on this issue and will present such to the Board sometime in July.
• HB 6401 AN ACT RECOGNIZING PARENTAL ALIENATION SYNDROME AS A FORM OF EMOTIONAL CHILD ABUSE: Along with bills such as HB 5877 restricting the use of Guardians ad Litem in highly contested family court cases, these bills all failed despite the public forum on parental alienation held at the state Legislative Office Building early on during the session. The drafted bills were highly controversial and ultimately did not even get a public hearing.
• HB 5915 AN ACT CONCERNING THE GRANTING OF LIMITED PRESCRIPTIVE AUTHORITY TO NATUROPATHIC PHYSICIANS TO IMPROVE PATIENT ACCESS TO CARE: Along with HB 6544 and HB 5902, this bill would have allowed the Department of Public Health, in concert with the Naturopaths and the Connecticut State Medical Society to agree on a formulary that was appropriated and general amended the law to authorize limited prescriptive authority to naturopathic physicians to improve patient access to care. This bill was opposed by the DPH, which takes the position that once a scope of practice review has been undertaken by the Department, the legislature must make changes and not give the task of governing (or setting formularies in this case) back to DPH.
• HB 7140: would have required, among other things that motor cycle operators and their passengers be required to wear helmets. CA testified in favor of this portion of the bill, but ultimately this bill did not pass.
• PSYPACT: While the PsyPact bill did not pass as legislation, there is a commitment by the Department of Public Health to study this issue and bring back a recommendation to the Public Health Committee next year and compare it with the expansion of telehealth services in Connecticut. CPA will be involved heavily on this issue.

Legislation of Interest to CPA which PASSED

• HB 7125 AN ACT CONCERNING MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS. (PARITY): This bill, several years in the making and with a great coalition of patient groups such as the Mental Health Association, CT NAMI, CPA and the CT Psychiatrists, finally passed. The bill requires:
  • that each health carrier annually report to the insurance commissioner about mental health and substance use disorder benefits and nonquantitative treatment limitations. The report must include: (a) the process used to develop and select criteria to assess the medical necessity of mental health and substance use disorder benefits and medical and surgical benefits and (b) all nonquantitative treatment limitations applied to mental health, substance use disorder, and medical and surgical benefits.
  • that “mental health and substance use disorder benefits” are defined as all benefits used to treat a mental health condition or substance use disorder that is listed as a mental disorder in the International Classification of Diseases or a mental disorder as defined by the American Psychiatric Association.
  • that the report by carriers contain an analysis of the process, strategies, evidentiary standards used to develop and apply the medical necessity criteria and nonquantitative treatment limitations. The analyses must disclose information that sufficiently demonstrates that the carrier applied nonquantitative treatment limitations comparably, and not more stringently, to mental health and substance use disorder benefits and medical and surgical benefits consistent with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and applied nonquantitative treatment limitations equally across mental health, substance use, and medical and surgical benefits.
  • that the carrier demonstrate that it complied with state mental and nervous conditions coverage, prescription drug coverage, step therapy laws, and federal mental health parity laws.
  • that the carrier analysis must disclose each factor considered, regardless of whether it was accepted or rejected, in designing and determining whether to apply nonquantitative treatment limitations; disclose all evidentiary standards, whether quantitative or qualitative, or provide a clear description of the factor if no evidentiary standard was used; provide the comparative analyses that show that the written processes and strategies used to design and apply nonquantitative treatment limitations to mental health and substance use disorder benefits are comparable to, and applied no more stringently than, those used to design and apply nonquantitative treatment limitations to medical and surgical benefits; and provide the comparative analyses that show the processes and strategies used to apply nonquantitative treatment limitations to mental health and substance use disorder benefits are comparable to, and applied no more stringently than, those used to apply nonquantitative treatment limitations to medical and surgical benefits.
  • that beginning in 2021, the Insurance Commissioner issue an Annual Report to the Insurance and Real Estate Committee as well as the Attorney General, Healthcare Advocate, and the Office of Health Strategy’s executive director. The health carrier’s names and identities, including the names and identities of entities they contract with, are confidential, and the commissioner is prohibited from making them public. The commissioner is also prohibited from disclosing the results of the analysis in a manner likely to compromise their financial, competitive, or proprietary nature. The bill specifies that it does not require any disclosure in violation of federal confidentiality laws.
  • that the Insurance and Real Estate Committee may hold a public hearing on the reports. The insurance commissioner or his designee must attend and inform the committee whether, in his opinion, each health carrier submitted the required reports; applied nonquantitative treatment limitations equally across mental health, substance use, and medical and surgical benefits; and complied with certain state mental and nervous conditions coverage, prescription drug coverage, step therapy laws, and federal mental health parity laws.

• HB 7424 AN ACT CONCERNING THE STATE BUDGET FOR THE BIENNIUM ENDING JUNE THIRTIETH, 2021, AND MAKING APPROPRIATIONS THEREFOR, AND IMPLEMENTING PROVISIONS OF THE BUDGET. (The budget): This bill made several last- minute changes to the Licensed Professional Counselor (PC) and Marital and Family Therapist (MFT) statutes to allow for Associate Licensure. For several years, both the PCs and the MFTs have been looking to have an associate licensure category for those LPCs and MFTs practicing under professional supervision while pursuing full licensure.
  • § 162-175of the bill clarifies that qualify for an associate license, the applicant must meet certain educational and clinical training requirements. The bill also prohibits anyone who is unlicensed from using the title (1) “licensed professional counselor associate” or “professional counselor” or any title, words, letters, or abbreviations that may reasonably be confused with licensure or (2) “licensed marital and family therapist associate.” Existing law similarly prohibits unlicensed people from using a title that indicates that they are fully licensed LPCs and MFTs. The bill allows DPH to take disciplinary actions against associate LPC and MFT licensees under the same grounds for which she may take actions against other LPC and MFT licensees (e.g., fraud or deceit in obtaining the license).
  • §§ 176-182of the bill creates a licensure program for art therapists and generally prohibits unlicensed individuals from using the “art therapist” title. To receive a license, an applicant must (1) hold a graduate degree and be credentialed or certified by the Art Therapy Credentials Board or (2) qualify for licensure by endorsement. The bill also provides for nonrenewable temporary permits authorizing the holder to work under a licensed person’s supervision. This has been a proposed bill for six years and has finally passed also with severe restrictions.

• HB 7159 AN ACT ADDRESSING OPIOID USE: This bill updates and adds to existing laws with respect to providers and prescribers of opioids. The bill:
  • requires pharmacists to offer consultations to all patients when dispensing a prescription, not just Medicaid patients as under current law, and allows pharmacists to designate a trained pharmacy technician to access the state’s Connecticut Prescription Monitoring and Reporting System (CPMRP);
  • specifies that prescribing practitioners or their agents are not prohibited from disclosing CPMRS information about pharmacy or veterinarian-dispensed prescriptions to the Department of Social Services (DSS) to administer Medicaid;
  • requires drug manufacturers and wholesalers to report to the Department of Consumer Protection (DCP) decisions to terminate or refuse an order from a pharmacy or prescribing practitioner for schedule II to V controlled substances;
  • prohibits life insurance and annuity policies or contracts from excluding coverage solely based on an individual having received a prescription for naloxone;
  • requires prescribing practitioners who prescribe an opioid drug with more than a 12-week supply to establish a treatment agreement with the patient or discuss a care plan for chronic opioid drug use;
  • requires higher education institutions to develop and implement a policy on the availability and use of opioid antagonists by students and employees;
  • requires the Department of Mental Health and Addiction Services (DMHAS) to review and report on literature about the efficacy of providing home-based treatment and recovery services for opioid use disorder to certain Medicaid beneficiaries;
  • requires treatment programs under DHMAS to educate patients with opioid use disorder and family members on opioid antagonists and how to administer them;
  • makes various changes to credentialing of certain emergency medical services (EMS) personnel;
  • requires hospitals to administer a mental health screening or assessment on patients treated for a nonfatal opioid drug overdoses if it is medically appropriate to do so; and
  • requires DMHAS to study and report on the protocol for police detention of someone suspected of overdosing on an opioid drug and the implications of involuntarily transporting such a person to an emergency department.
• SB164 AN ACT CONCERNING WORKERS’ COMPENSATION BENEFITS FOR CERTAIN MENTAL OR EMOTIONAL IMPAIRMENTS, MENTAL HEALTH CARE FOR POLICE OFFICERS AND WELLNESS TRAINING FOR POLICE OFFICERS, PAROLE OFFICERS AND FIREFIGHTERS. This bill:
  • establishes the eligibility requirements for these officers and firefighters to receive PTSD benefits;
  • limits the benefits’ (a) duration to 52 weeks and (b) availability to within four years after the qualifying event;
  • reduces the amount of weekly PTSD benefits an officer or firefighter may receive by the amount of other benefits he or she receives (e.g., from a pension, Social Security, or disability insurance), if the total benefits exceed the officer’s or firefighter’s average weekly wage; and
  • establishes a process for employers to contest PTSD claims.
  • The bill prohibits a law enforcement unit from disciplining police officers solely because they seek or receive mental health care services or surrender their work weapons or ammunition. The diagnosis and treatment of a police officer or firefighter may be conducted by a board-certified psychiatrist or a licensed psychologist specializing in the treatment of PTSD. It also requires law enforcement units to request that officers seek a mental health examination before returning their weapons or ammunition.
• HB 7198 AN ACT CONCERNING SOCIAL WORKERS. This bill:
  • which CPA supported, prohibits anyone from using the title “social worker,” or any associated initials, or advertising services as a social worker unless he or she (1) has a bachelor’s or master’s degree in social work from a program accredited by the Council on Social Work Education (CSWE); a doctorate in social work; if educated outside of the U.S. or its territories, completed an education program that CSWE deems equivalent. The bill exempts state employees with the title social worker and municipal employees with this title hired before July 1, 2019. Existing law already allows any person employed by the state before October 1, 1996, with the title in the social work series of the classified service to have such a title to describe or perform his or her duties, but as of October 1, 2019, the bill requires the state, on any posting for a job in the social work series of classified service that does not require a social work license, to specify that the preferred qualification is a bachelor’s or master’s degree in social work from a CSWE accredited program or a doctorate in social work.

OTHER BILLS OF INTEREST
In addition to these bills, legislation passed on juvenile justice, gun storage, gun safety, school climate and unrestricted play for children in schools as well as a bill that allows a child charged with a delinquency offense involving an “act of fire starting” to file a motion with the court for an evaluation to determine if he or she would benefit from participating in a fire-starting behavior treatment program.

ADMINISTRATIVE ISSUES
In addition to the legislative issues, CPA met with the Department of Social Services and was successful in correcting neuropsychological testing code errors and implementation of new insurance codes.

A bill was not introduced this year to allow for prescription privileges for psychologists; it will likely be introduced in the 2019 Legislative Session. Of particular concern from the opposition (largely psychiatrists, doctors, and APRNs) on that issue is the amount of time and duration of supervision and potentially the formulary under which a psychologist could prescribe.

Bills That Were of Interest to CPA during the Legislative Session:

• HB 5149 – An Act Concerning Sober Living Homes – this bill passed and allows sober homes to voluntarily registered as certified sober homes in order that consumers can choose quality outpatient care.
• HB 5212 – An Act Concerning a Grandparent’s Right to Visitation with his or her Grandchild – did not pass for the third year in a row.
• Sexual Assault Bills HB 5246, SB 238, – bills lifting the current statute of limitations on sexual assault cases did not pass.
• SB 479 – An Act Concerning Immunity From Civil or Criminal Liability for Persons providing Medical Assistance or Intervention in a Child Abuse or Neglect Case – This bill provides immunity from civil and criminal liability to any person, institution, or agency that, in good faith, provides professional medical intervention or assistance in any proceeding involving child abuse or neglect. The bill’s immunity applies to liability that might otherwise arise from or is related to actions such as: 1. causing a photograph, x-ray, or physical custody examination to be made; 2. causing a child to be taken into emergency protective custody 3. disclosing a medical record or other information pertinent to the proceeding; or 4. performing a medically relevant test.   The bill also eliminates current immunity from civil or criminal liability for any person, institution, or agency that, in good faith, does not report suspected child abuse or neglect or alleged sexual assault of a student to the DCF or law enforcement as required or permitted by law. The bill retains immunity for a person, institution, or agency that, in good faith, makes such a report and applies the immunity to civil or criminal liability that might otherwise arise from, or is related to, making the report. Currently, this immunity applies to civil or criminal liability that might otherwise be incurred or imposed.
• HB 5575 – An Act Concerning the Appointment of a Qualified, Licensed Health Care Professional to Provide Treatment of an Evaluation in Connection with a Family Relations Matter – This bill establishes a process for selecting qualified, licensed health care providers in family relations matters involving court-ordered treatment or evaluation of parents and children.  The bill requires the court to permit the parent to select the treatment provider for him or herself and allow the parent or legal guardian to do so for the child. When the child’s parents do not agree on a provider within a specific timeframe, the bill requires the court to select the provider. In doing so, the court must consider the parents’ insurance coverage and financial resources.  When the parties agree or the court orders that a parent or child undergo an evaluation from a qualified, licensed healthcare provider, the court must first find that the parties can afford to pay the provider.  The bill establishes the (1) components of the court order and (2) deadline by which the provider must file a report containing the results of the evaluation with the court. The parties must have a reasonable time to examine the report before the case is heard and the court must seal the report
• HB 5163 – An Act Concerning the Department of Public Health’s Recommendations Regarding Various Revisions to the Public Health Statutes – Students who graduate with advanced degrees in marital and family therapy, professional counseling, or psychology may practice without a license in order to complete the supervised work experience required for licensure, but only if supervised by a person licensed in their respective profession.  This bill permits these graduates to practice in this unlicensed capacity for up to two years after completing the supervised work experience,  if they failed the respective licensing examination. Under current law, professional counseling and psychology students may practice in this manner until they are notified that they failed the respective licensing examination, or one year after completing the supervised work experience, whichever occurs first. For marital and family therapist students, current law does not specify that the licensure exemption ends on the earlier of these two dates.
• SB 384 – Mental Health Parity – This data bill passed the Senate but not the House.  This Insurance Companies were opposed to the bill.
• SB 302 – Telehealth – this bill allows for the ability to prescribe medications under certain circumstances; it allows telehealth providers to prescribe non-opioid Schedule II or III controlled substances using telehealth to treat a psychiatric disability or substance use disorder if certain conditions are met; modifies requirements for telehealth providers to obtain and document patient consent to provide telehealth services and disclose related records; adds registered nurses and pharmacists to the list of health care providers authorized to provide telehealth services. The bill specifies that its provisions do not prevent a licensed or certified health care provider from using telehealth to order medication or treatment for hospital inpatients in accordance with the federal law.
• HB 5294 – An Act Concerning Naturopaths – this bill did not pass and would have allowed the Department of Public Health to set up a formulary for medications that could be prescribed by naturopaths.
• SB 244 – An Act Requiring Behavior Analysts to be Mandated Reporters of Suspected Child Abuse and Neglect – this bill passed.
• SB 315 – An Act Concerning Minor Revisions to the Statutes of the Department of Children and Families and Establishing a Pilot Program to Permit Electronic Reporting by Mandated Reporters – passed and is self-explanatory as CPA was watching the electronic reporting section.