Public Health Committee
JOINT FAVORABLE REPORT
Bill No.: HB-5046
AN ACT ADOPTING THE INTERSTATE MEDICAL LICENSURE COMPACT
Title: AND PSYCHOLOGY INTERJURISDICTIONAL COMPACT.
Vote Date: 3/11/2022
Vote Action: Joint Favorable
PH Date: 3/7/2022
File No.: 123
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:
Governor's Administration
Public Health Committee
REASONS FOR BILL:
This bill is intended to address aspects of a significant workforce shortage in the medical
field. It enters Connecticut into the Interstate Medical Licensure Compact (IMLCC) and the
Psychology Interjurisdictional Compact (PsyPACT). The IMLCC expedites the process by which
physicians can become licensed in multiple states, allowing them to complete a single application
to receive licenses in each of the separate states where they will practice. PsyPACT allows
unlimited telehealth and limited in person practice across member state boundaries.
Psychologists can apply for either or both options for treatment of patients.
RESPONSE FROM ADMINISTRATION/AGENCY:
Manisha Juthani, Commissioner, Connecticut Department of Public Health:
DPH is in support of this bill. By joining these compacts, we can facilitate telehealth and in-
person practice across state lines, while maintaining the public protections provided by
traditional single state licensing. During the declared COVID-19 emergency, executive orders
suspended in-state licensure requirements for certain out of state licensed practitioners. As
these orders expire, these compacts will allow physicians and psychologists to continue to
practice across state lines, benefiting both patients and providers. Participation in PsyPACT
will help address the ongoing mental health crisis by authorizing psychologists licensed in
other participating states to provide telehealth services to CT residents. PsyPACT also allows
participating psychologists to work in-person in CT for a limited period each year. Based on
other states experiences, the Department anticipates a 10 to 15% increase in the number of
physicians licensed in CT if the Legislature adopts the IMLCC.
Christopher Arnold, Northeast Region Liaison, United States Department of Defense:
Compacts like these can be tremendously helpful for military spouses in the healthcare field.
Barriers to the transfer and acceptance of certifications and licenses that occur when state
rules differ can dramatically impact the financial well-being of military families. Frequent
moves and cumbersome requirements limit career options for military spouses. Removing
these barriers can speed the assimilation of the family into its new location and strengthen
the employee pool for a state. The pandemic demonstrates that interstate licensure compacts
such as PsyPACT can provide a permanent solution to leverage underutilized medical talent
to meet labor shortages in high-need areas.
Michael J. Parisi, Chairman, Board of Examiners for Physical Therapists:
This bill will help meet prolonged fluctuations in staffing for hospitals, which often rely on
traveling physical therapists. To practice in CT, these travelers would have to submit a
Verification of Licensure form to DPH, which frequently resulted in long delays. As the result
of short staffing, queues to begin therapy are often longer and reduces the frequencies of
treatment. These compacts will dramatically reduce delays in bringing travelers into the
workforce whose skilled services are needed immediately.
NATURE AND SOURCES OF SUPPORT:
Connecticut Hospital Association, (CHA):
CHA supports this bill but takes this opportunity to request continued deliberation and
discussion on compacts not recommended for legislative action this session, such as the
nurse licensure compact. Participation in licensure compacts is one tool to address workforce
shortage issues and must be coupled with other steps to improve the education pipeline,
support retention and recruitment, and improve opportunities for career advancement.
Connecticut State Medical Society, (CSMS:
While CSMS is supportive of allowing physicians to utilize the streamlined process of the
IMLCC, they have serious reservations about the possible unintended consequences.
Telehealth companies such as Teledoc have created a system of highly fragmented in
providing medical care resulting in important medical information not being included in the
patients medical records. Entrance into the IMLCC would allow telehealth companies to
quickly ramp up their physician networks in CT, further fragmenting care. CSMS encourages
that In conjunction with this bill, the CGA must enact protections to ensure corporate
telehealth entities do not become a substitute for care. Harvard Pilgrim and Anthem have
already crafted telehealth only primary care networks and are offering these plans in CT.
Dr. Jennifer Doran, President, Connecticut Psychological Association, (CPA):
CPA support this bill and details several of the benefits of joining PsyPACT. It increases
access to care and expands the number of providers available; It increases continuity of care,
particularly in situations where patient location is transient or varies; It increases protection of
the public by ensuring providers crossing state lines are appropriately credentialed in their
home state; and it clearly regulates the conditions through which interstate practice is
permissible. Without PsyPACT, we continue to experience chronic disruptions in mental
health care for patients who have variability in their physical location.
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Lisa Robin, Chief Advocacy Officer, Federation of State Medical Boards:
The IMLCC facilitates interstate cooperation and the transfer of information between member
states and territories while regulatory control remains exclusively with the respective state
medical boards. IMLCC has implemented a sustainable business model based solely on user
fees without the need for additional member state support or membership fees. The IMLCC is
a testament to the work of medical regulatory boards, physicians, and other key stakeholders
to reach consensus in support of a state-based solution that simultaneously expedites state
medical license portability while ensuring public protection.
Vic Vaughan, Past President, CT Physical Therapy Association:
Staffing for physical therapists has long been a major issue for many organizations which has
been made substantially worse by the pandemic. Health care practices often need temporary
staff to bridge a gap in services arising from maternity leave, illness, injury, surgery, staff
resignations and the regular challenge of finding full-time permanent staff. There are
companies who provide traveling PT services, however under the current licensure
regulations it can often take several months before any traveling PT is licensed in
Connecticut so that they can practice.
Hartford HealthCare:
A multi-state physician license will improve the continuum of care to allow clinicians to
provide virtual care to patients who travel between Connecticut and compact member states,
improve access to physicians and specialists and expand the pool of physicians to work in
rural and underserved areas. Participation in PSYPACT will increase access to mental health
providers particularly in areas of the state where there is limited access and enable providers
to follow their patients as they travel home for school vacations and prolonged out-of-state
residencies.
Meari Avery, AARP Connecticut:
In recent years, interstate licensure compacts have made it easier for nurses, physicians,
physical therapists, and other healthcare workers to relocate to other states, provide
emergency assistance in times of need, and practice telehealth across state lines. These
compacts benefit healthcare professionals as well as their patients. Joining the IMLCC will
give CT residents better access to specialized care, which could prove especially beneficial
for older adults.
Wyatt Bosworth, Assistant Counsel, Connecticut Business & Industry Association:
The IMLCC currently includes 34 states and allows physicians to qualify to practice medicine
across state lines if they meet the compacts eligibility requirements. Under the compact,
individual states issue licenses, but the application process is routed through the compact.
Psychologists licensed in CT, under the PsyPACT, can obtain authorization to practice
interjurisdictional telepsychology, and receive temporary authorization to practice
interjurisdictional in-person psychology services. Streamlining licensing will help the state fill
the current shortage among mental and behavioral health providers and enhance access to
care for thousands of residents.
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Additional Sources of Support:
Howard Sovronsky, Chief Behavioral Health Officer, Connecticut Childrens
Anthony Yoder, Health & Public Policy Co-Chair, American College of Physicians-CT
Mariella LaRosa, CEO, HAVEN
Barbara Bunk, Legislative Committee Member, CT Psychological Association
Kyle Zebley Executive Director, ATA Action
Janet Dee Spoltore, Director of Student Counseling and Health Services, CPA
Mark Spellman, Executive Committee Member, CT Psychological Association
Dr. Meghan Butler, CT Psychological Association
Daniel Freess, Past President, Connecticut College of Emergency Physicians
Stephanie Leite, Forensic Intelligence, LLC
Ralph P. Balducci, Ph.D.
Kathleen Chapman, Ph.D.
Dr. David Bendor
Wendy Levy, Assistant Professor, Yale University School of Medicine
NATURE AND SOURCES OF OPPOSITION:
No sources of opposition were provided.
Reported by: Dallas Emerle Date: 3/23/2022
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