OLR Bill Analysis

sHB 5893

AN ACT ESTABLISHING AN EMERGENCY RESPONSE SYSTEM OF VOLUNTEER HEALTH CARE PRACTITIONERS.

SUMMARY:

This bill creates a framework for health care practitioners licensed out-of-state to provide volunteer services in Connecticut during an emergency declared by the governor, provided they meet certain criteria. The practitioners must:

The bill prohibits the practitioners from providing health care services outside the scope of their practice or that of a comparable Connecticut licensee. (But it is unclear which state's scope of practice prevails, if different. )

The bill allows the appropriate licensing board or other disciplinary authority to administratively sanction practitioners for unauthorized actions.

It allows DPH or DEMHS to adopt implementing regulations.

EFFECTIVE DATE: January 1, 2010

PRACTICE DURING EMERGENCY DECLARATION

The bill allows out-of-state, volunteer health care practitioners, during a declared emergency (i. e. , a civil preparedness or public health emergency declared by the governor), to provide health care services as if licensed in Connecticut, provided they meet licensing, registration, and other criteria.

The bill defines a “health care practitioner” as anyone licensed out-of-state to provide health care, mental health, or emergency medical services through a licensed medical services provider, or general or specialized surgery. The definition also includes anyone licensed in Connecticut to provide health care services in specified areas. (But it is unclear how the bill applies to Connecticut licensees. )

The bill defines a “volunteer health care practitioner” as a health care practitioner who provides health care services, whether or not for compensation. It includes out-of-state residents employed by disaster relief organizations providing services in Connecticut during an emergency declaration. But it does not include practitioners compensated under a preexisting employment relationship requiring them to provide health care services in Connecticut.

The bill defines “health care services” as care, service, or treatment of an illness or dysfunction of, or injury to, the human body, including: (1) preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care; (2) counseling, assessment, procedures or other mental health services; and (3) the selling or dispensing of prescription devices, drugs, equipment, or other items.

LICENSE AND SCOPE OF PRACTICE REQUIREMENTS

The bill requires volunteer health care practitioners to be licensed. It bars them from providing health care services under a license that is suspended, revoked, voluntarily terminated, under threat of sanction, or subject to an agency order limiting or restricting the scope of practice.

The practitioners may provide only those health care services that are within (1) their scope of practice in the state where they are licensed or (2) the scope of practice for a comparable Connecticut licensee.

REGISTRATION REQUIREMENT

A volunteer health care practitioner must register with a volunteer health care practitioner system organization in order to provide health care services during an emergency (see COMMENT). The organization must (1) accept registration applications before or during an emergency, (2) include information about the licensure and good standing of volunteer health care practitioners that is accessible by authorized persons, and (3) be able to confirm whether a volunteer health care practitioner is licensed and in good standing in another state before he or she can provide health care services. The organization must also meet one of the following conditions:

If the DPH or DEMHS commissioner or a designee asks the organization, it must confirm whether a practitioner is registered and the system indicates that the practitioner is licensed and in good standing.

LIMITS ON VOLUNTEER HEALTH CARE PRACTITIONERS

During an emergency declaration, DPH and DEMHS may issue orders to limit, restrict, or otherwise regulate volunteer health care practitioners. They may, among other things, limit (1) how long they can practice; (2) where they may practice; (3) the practitioners who can serve; and (4) any other matters necessary to coordinate the provision of health care services during the emergency.

An entity that uses volunteer health care practitioners to provide health care services in Connecticut (host entity) must (1) consult with DPH and DEMHS and, to the extent practicable, coordinate its activities with the agencies to use the practitioners efficiently and effectively and (2) comply with any order from the DPH or DEMHS commissioner.

ADMINISTRATIVE SANCTIONS

A volunteer health care practitioner who provides health care services without being licensed or registered, in violation of a DPH or DEMHS order, or outside the scope of his or her practice or of a comparable Connecticut licensee, is deemed to have “engaged in unauthorized practice. ” For a violation to occur, the practitioner must have had reason to know of any limitation, modification, or restriction on providing the services or that a similarly licensed Connecticut practitioner would not be permitted to provide such services. Under the bill, a practitioner has reason to know these things if, from all the facts and circumstances known to him or her at the relevant time, a reasonable person would conclude that providing the services was impermissible.

The bill allows a licensing board or other Connecticut disciplinary authority (e. g. , DPH) to impose administrative sanctions on (1) state-licensed, volunteer health care practitioners for conduct related to an out-of-state emergency and (2) out-of-state, licensed practitioners for conduct related to an in-state emergency. In determining whether to impose such sanctions, the board or authority must consider the circumstances surrounding the conduct, including any exigent circumstances, and the practitioner's scope of practice, education, training, experience, and specialized skill.

The board or other authority must report any administrative sanctions it imposes on an out-of-state licensee to the appropriate licensing board or disciplinary authority in the licensee's state.

CONSTRUCTION

The bill does not limit the rights, privileges, or immunities provided to volunteer health care practitioners under any other provision of law.

It permits DPH and DEMHS, pursuant to the Emergency Management Assistance Compact (EMAC), to incorporate into the state's emergency forces volunteer health care practitioners who are not officers or employees of this state, a political subdivision of this state, or a municipality or other local government within this state. Except for this, the bill cannot affect requirements for the use of volunteer health care practitioners under EMAC.

IMPLEMENTING REGULATIONS

The bill allows DPH or DEMHS to adopt implementing regulations. The regulations “must reference the coordination and implementation requirements prescribed in EMAC. ” In adopting the regulations, the departments must consider comparable regulations of similarly empowered agencies in other states in order to achieve uniformity and consistency to a reasonable extent.

COMMENT

Emergency and Emergency Declaration

The bill appears to use these terms synonymously. But “an emergency declaration” means the governor's declaration of a civil preparedness or public health emergency. An “emergency” is any instance in which the President determines that federal assistance is needed to supplement state and local efforts and capabilities to save lives and protect property, public health and safety; or to avert or lessen the threat of a disaster or catastrophe. It includes a public health emergency.

COMMITTEE ACTION

Public Safety and Security Committee

Joint Favorable Change of Reference

Public Health Committee

Joint Favorable Substitute