Public Health Committee
JOINT FAVORABLE REPORT
Bill No.: SB-1
AN ACT EQUALIZING COMPREHENSIVE ACCESS TO MENTAL,
BEHAVIORAL AND PHYSICAL HEALTH CARE IN RESPONSE TO THE
Title: PANDEMIC.
Vote Date: 3/26/2021
Vote Action: Joint Favorable
PH Date: 3/17/2021
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:
The Public Health Committee
Senator Martin Looney
REASONS FOR BILL:
This legislation includes various provisions related to public health, pandemic preparedness,
racial disparities in health care, and related topics, as follows:
requires boards of education to conduct exit interviews with students who withdraw
from school before graduating, and provide them with resources on certain topics for
at least a year after withdrawing;
requires DPH to adopt regulations to provide for the certification and education of peer
support specialists;
requires DMHAS to develop and post online a mental health toolkit to help employers
address employee mental health needs arising due to COVID-19;
requires DPH to study the states COVID-19 response and report the studys findings
to the Public Health Committee by January 1, 2022;
requires DPH to designate an employee within its Office of Public Health
Preparedness and Response to serve as the pandemic preparedness officer;
declares as state policy the recognition that racism is a public health crisis;
creates a Truth and Reconciliation Commission to examine racial disparities in public
health, develop legislative proposals to address them, and annually report to the
Public Health Committee;
sets a minimum nurse staffing ratio of two nurses per patient in ICUs;
 requires DPH, within available appropriations, to establish a program to advance
breast health and breast cancer awareness, including outreach to young women of
color on the importance of early detection;
requires DPH to study whether the department should establish a state certification
process for doulas and report to the Public Health Committee by January 1, 2022;
requires hospitals to include training in implicit bias as part of their regular training to
staff members who provide direct care to women who are pregnant or in the
postpartum period;
establishes a task force to study racial inequities in maternal mortality and severe
maternal morbidity in the state and report to the Public Health Committee by January
1, 2022;
requires DPH to establish a pilot program allowing EMS personnel, in coordination
with community health workers, to conduct home visits for individuals at high risk of
being repeat users of EMS services, to help them manage chronic illnesses and
adhere to medication plans;
requires physicians to perform mental health examinations on patients during annual
physical exams;
requires OPM, in consultation with several other agencies (including DPH), to study
the impacts of the COVID-19 pandemic on the state, including the disparate impact on
individuals based on race, ethnicity, language, and geography, and requires the DPH
commissioner to report to the Public Health Committee by February 1, 2022;
requires municipalities to notify DPH if they appoint an acting local health director and
requires, rather than allows, DPH to appoint someone as a local health director if there
is a vacancy for 30 days or more;
sets requirements for state agencies or state entities that, directly or by contract,
collect demographic data related to health care or public health, such as that they
collect the data in a manner that allows for its aggregation and disaggregation;
makes various changes to the law on hospital community benefit programs, such as
(a) modifying reporting requirements and (b) requiring OHS to establish a minimum
community benefit and community building spending threshold for hospitals based on
specified criteria;
requires DPH, in consultation with DCF, to conduct a study to identify areas where
access to quality and affordable mental and behavioral health care for children is
limited, and report to the Public Health Committee by January 1, 2022;
adopts the Uniform Emergency Volunteer Health Practitioners Act, under which (a)
health care professionals (including veterinarians) may register to provide services
during declared emergencies in other states, (b) healthcare facilities and disaster relief
organizations may rely on the registration system to confirm that registrants are
appropriately licensed and in good standing, and (c) participating providers are
generally protected from civil liability if they meet certain standards;
makes an unspecified General Fund appropriation to DPH in FY 22 to expand services
of existing school-based health centers and establish new ones;
makes a $6 million General Fund appropriation to DMHAS in FY 22 to make mobile
crisis intervention services available 24/7 in each mobile crisis region to respond to
acute mental health emergencies;
makes a $500,000 General Fund appropriation to DPH in FY 22 to provide three-year
grants to community-based health care providers in primary care settings.
Page 2 of 7 SB-1
RESPONSE FROM ADMINISTRATION/AGENCY:
The Connecticut Department of Public Health:
The Department of Public Health (DPH) provided written testimony on SB 1, specifically on
Sections 2, 4, 5, 8 through 10, 12 through 17, 19, 22 through 32, 33 and 35. This bill includes
seven sections that require DPH to conduct studies. As stated in the testimony, the
Department is concerned that they would be unable to complete all the required studies
within the specified timeframes. DPH recommends "combining the studies and staggering
timelines to allow the Department the opportunity to do the work, as it is anticipated that we
will be continuing our response to the COVID-19 pandemic into the Fall of 2021, which could
affect our ability to complete the studies."
Additionally, Section 2 requires DPH to adopt regulations to implement a peer support
specialist certification program. The Department of Mental Health and Addiction Services
(DMHAS) currently has a training and certification program in place for recovery support
specialists which is comparable to the peer support specialist proposed in this bill. The
Department recommends continuation of the DMHAS program in lieu of adopting regulations
to establish a certification program through DPH.
Another recommendation offered refers to Section 27, which "allows DPH to impose
administrative sanctions upon a practitioner who is not licensed in Connecticut for conduct in
this state in response to an in-state emergency. The bill does not define administrative
sanctions" nor does it set forth the standards for which a sanction can be imposed. As
drafted, the sections provisions could be subject to substantial legal challenges."
Other recommendations and comments outlined in the testimony pertained to additional
funding and timeline of deadlines.
Senator Martin Looney, 11th District:
Senator Looney provides testimony in support for the passage of this legislation. As stated in
the written testimony, Senate Bill 1 requires the Department of Public Health to conduct a
study on "the state's COVID19 response and submit a report the Public Health Committee
regarding their recommendations for policy changes and amendments to the general statutes
necessary to improve the state's response to future pandemics.
SB 1 requires DPH to designate an employee within its Office of Public Health Preparedness
and Response to serve as the pandemic preparedness officer to be responsible for, among
other things, providing periodic updates to members of the General Assembly during a
pandemic-related public health emergency.
Additionally, this bill declares that the State of Connecticut recognize racism is a public health
crisis. Further, the bill creates a Truth and Reconciliation Commission to examine racial
disparities in public health across state and local government. The bill also mandates
improvements to our data collection practices and makes changes to our hospital community
benefits program statutes which would encourage the use of hospital community benefit
plans to address racial and ethnic health disparities and facilitate the integration of such plans
with the actual needs of the community.
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The bill also takes steps to improve the health of women of color, specifically during the
pregnancy and postpartum period by requiring each hospital to provide implicit bias training
to staff members who provide direct care to individuals who are pregnant or are in the
postpartum period. It also establishes a task force to study racial inequities in maternal
mortality and severe maternal morbidity in the state and requires DPH to conduct a study on
whether Connecticut should certify doulas as trained, nonmedical professionals who provides
continuous physical, emotional and informational support to pregnant individuals.
Connecticut Senate Democrats, Connecticut General Assembly:
The Connecticut Senate Democrats provide testimony in favor of this bill. As stated in the
testimony, this legislation was written to address several areas that should be considered
urgent issues. Citizens of Connecticut have been mentally and physically impacted by the
COVID-19 pandemic, and "this bill seeks to provide additional recourses to meet those
needs." Specifically, Senate Bill 1 " investigates and responds to the needs of children by
requiring a study into where affordable care for children is limited in our state, appropriating
funds for school-based health center expansion and creation and having Boards of Education
conduct interviews with students as they withdraw from school where they will provide
resources."
Additionally, it establishes a peer support specialist certification program which would
"empower employers to identify and support the mental health needs of employees. SB 1
also establish a pilot program to conduct home visits with patients who are at risk for
repetitive use of emergency services and work to manage their chronic illnesses or
medication plans."
Overall, Senate Democrats support this bill as it " will lead our state into a stronger and safer
future and will protect and provide mental and physical wellbeing amongst our residents."
Victoria Veltri, Office of Health Strategy:
Victoria Veltri offers testimony in support of this bill on behalf of the Office of Health Strategy
(OHS). OHS offers comments specifically on Sections 6, 17 and 18 of Senate Bill 1. Ms.
Veltri states, "I support SB 1s declaration of racism as a public health crisis in Section 6. This
important designation continues the States efforts to promote meaningful policy reforms that
address longstanding inequities for many communities in our state. OHS believes it is
paramount to adopt a health in all policies strategy to address the conditions that affect
health."
OHS is also supportive of the initiative set in Section 17 that requires state entities that collect
data concerning race, ethnicity and primary language for residents receiving health care
services and should do so in a manner that allows for aggregation. OHS requests that "while
this section of SB 1 focuses solely on state entities, having common standards greatly
enhances the ability of all stakeholders to better understand the full patient experience across
all health care settings."
NATURE AND SOURCES OF SUPPORT:
Jennifer Barahona, Chief Executive Officer, Norwalk ACTS:
Jennifer Barahona offers written testimony in strong support of the passage of this legislation,
particularly Sections 6 and 7 "that would declare racism as a public health crisis in the state
Page 4 of 7 SB-1
and establish a commission to study the impact of institutional racism on public health and
provide proposals to address disparities." COVID-19 has increased visibility on the issue of
inequitable systems within healthcare that cause less favorable outcomes to people of color
than their white counterparts.
As stated in the written testimony, "Our BIPOC citizens are facing two simultaneous health
crises, one caused by a global pandemic and the other by hundreds of years of structural
racism that continue to create inequities Racism clearly meets the criteria of a public health
crisis in that it affects large numbers of people, threatens health over the long-term, and
requires the adoption of larger-scale solutions."
Black and Brown United in Action:
The Black and Brown United in Action is a grassroots organization located in New Haven,
Connecticut. The organization offers testimony in support of this bill with recommended
amendments. They recognize racism as a public health crisis and supports and is in solidarity
with testimony provided by the Connecticut Campaign to Address Racism as a Public Health
Crisis, Hamden Action Now, Health Equity Solutions, and Power Up CT.
The testimony provides a background on racism in Connecticut and how deeply it has
affected the lives of black and brown citizens of Connecticut. As stated in the testimony, "[a]ll
the fieldwork and research into the COVID-19 global health pandemic neglected the impact
on Black and Brown people and heighted the presence of racist practices, language and
behaviors which have been allowed in the state for too long. Post pandemic, many Black and
Brown people will continue to struggle to pay their rent or mortgage, be treated unfairly and
disrespected on the job and paid unequally, struggle to pay rising utility and food costs, have
language access issues, be brutalized by the police, be targeted by racists on social media,
be exploited by the media, be used as data for projects about them which do not enhance
their true wellbeing, be denied access and opportunity to many resources including
healthcare, jobs and education, be forced to make daily survival decisions including risking
their own lives by sending their children into schools and buildings which are not fully
protected, risk their health and safety to keep the economy going."
The organization supports this legislation overall with suggested amendments provided by
the CT COVID-19 Hospital Rationing Coalition.
John Brady, Executive Vice President, AFTCT:
Mr. John Brady, a Registered Nurse and Executive Vice President for AFT Connecticut,
offers support for this bill with recommendations for changes. AFTCT is a union of 30,000
members in Healthcare, Education, and Public Service.
As stated in the testimony, AFT is the "largest union of Registered Nurses in Connecticut and
represent members from almost every healthcare profession." AFTCT suggest that " we must
recognize that some students who leave school before graduation do not withdraw, but
simply stop attending classes. It will be difficult to collect data on these students. We also feel
that resources to evaluate students during their academic careers and address issues in real
time, is very valuable." In addition to this recommendation, AFTCT states, "[s]ection 8
addresses staffing in ICUs. We support a ratio of two patients to one nurse in ICU. We would
suggest that this be listed as the minimum ratio required, with the ICU nurse able to reduce
that ratio to 1:1 based on acuity of the patients. The initiating of patient nurse ratios should
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not be offset by a decrease in non-nursing staff. We would also suggest that there would be
enforcement mechanisms, including fines, if hospitals violated this section." Mr. Brady added
that AFTCT specifically supports Sections 4-7 and 18 of this legislation.
Community Health Center Association of Connecticut:
The Community Health Center Association of Connecticut and the 17 health centers
operating within Connecticut collectively serve over 400,000 residents every year. They offer
support for the passage of this legislation. As stated in the testimony, "[t]his bill is an
important and vital step in addressing the racial and ethnic disparities highlighted by the
COVID-19 pandemicThis bill not only identifies and articulates the scope of the impact of
racial disparities on our public health system, but also sets in motion the process to begin
identifying and examining the aspects of our policy and government that need to change in
order to realize a shared vision of equitable access to health care."
Section 5 of this legislation creates an Office of Public Health Preparedness and Response,
which the Association believes is necessary improvement to the state's public health
infrastructure. Additionally, based on Sections 6 and 7 of this bill, the Association states,
"[t]his is an uncomfortable but necessary truth to acknowledge, and these sections represent
vital steps in addressing, working through, and eventually moving beyond the inequities in our
public health system. Connecticuts health centers have been on the front lines in identifying
and addressing health disparities in communities of color, and they are respected as a
trusted resource for individuals who experience barriers to accessing health care."
Kathleen Flaherty, Executive Director, Connecticut Legal Rights Project, Inc.:
Kathleen Flaherty, Esq. is the Executive Director of Connecticut Legal Rights Project (CLRP),
a statewide non-profit agency that provides legal services to low income adults with serious
mental health conditions. Ms. Flaherty offers strong support for the passage of this bill with
recommended amendments. As stated in the testimony, a recommendation for the committee
is to amend the bill to remove Section 2: " The State of Connecticut Department of Mental
Health and Addiction Services (DMHAS) endorses a statewide curriculum and examination of
peer support specialists. Peer support specialists