Sec. 20-12b. Physician assistant license. Temporary permit. Penalties.
Sec. 20-12l. PA Licensure Compact.
Sec. 20-14i. Administration of medication by trained persons.
Sec. 20-14o. Prescriptions for opioid drugs.
Sec. 20-14t. Provision of information re risk of sudden unexpected death in epilepsy.
Sec. 20-11b. Professional liability insurance required. Reports from insurance companies. Exception to insurance requirement. Retired physician providing free services. (a) Except as provided in subsection (c) of this section, each person licensed to practice medicine and surgery under the provisions of section 20-13 who provides direct patient care services shall maintain professional liability insurance or other indemnity against liability for professional malpractice. The amount of insurance which each such person shall carry as insurance or indemnity against claims for injury or death for professional malpractice shall not be less than five hundred thousand dollars for one person, per occurrence, with an aggregate of not less than one million five hundred thousand dollars.
(b) Each insurance company which issues professional liability insurance, as defined in subdivisions (1), (6), (7), (8) and (9) of subsection (b) of section 38a-393, shall on and after January 1, 1995, render to the Commissioner of Public Health a true record of the names and addresses, according to classification, of cancellations of and refusals to renew professional liability insurance policies and the reasons for such cancellation or refusal to renew said policies for the year ending on the thirty-first day of December next preceding.
(c) A person subject to the provisions of subsection (a) of this section shall be deemed in compliance with such subsection when providing primary health care or behavioral health care services at a clinic licensed by the Department of Public Health that is recognized as tax exempt pursuant to Section 501(c)(3) of the Internal Revenue Code of 1986 or any successor internal revenue code, as may be amended from time to time, provided: (1) Such person is not compensated for such services; (2) the clinic does not charge patients for such services; (3) the clinic maintains professional liability insurance coverage in the amounts required by subsection (a) of this section for each aggregated forty hours of service or fraction thereof for such persons; (4) the clinic carries additional appropriate professional liability coverage on behalf of the clinic and its employees in the amounts of five hundred thousand dollars per occurrence, with an aggregate of not less than one million five hundred thousand dollars; and (5) the clinic maintains total professional liability coverage of not less than one million dollars per occurrence with an annual aggregate of not less than three million dollars. Such person shall be subject to the provisions of subsection (a) of this section when providing direct patient care services in any setting other than such clinic. Nothing in this subsection shall be construed to relieve the clinic from any insurance requirements otherwise required by law.
(d) No person insured pursuant to the requirements of subsection (a) of this section with a claims-made medical malpractice insurance policy shall lose the right to unlimited additional extended reporting period coverage upon such person's permanent retirement from practice if such person solely provides professional services without charge at a clinic recognized as tax exempt under Section 501(c)(3) of said internal revenue code.
(P.A. 94-71, S. 1; P.A. 95-257, S. 12, 21, 58; P.A. 96-180, S. 64, 166; P.A. 04-221, S. 30; P.A. 25-96, S. 14.)
History: P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 96-180 required addresses to be included with the record of names in Subsec. (b), effective June 3, 1996; P.A. 04-221 added Subsec. (c) re exception from requirement to maintain insurance and Subsec. (d) re extended reporting period coverage for retired physicians providing certain services and made a conforming change in Subsec. (a), effective June 8, 2004; P.A. 25-96 amended Subsec. (c) by adding “or behavioral health care”.
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Sec. 20-12b. Physician assistant license. Temporary permit. Penalties. (a) The department may issue a physician assistant license to an applicant who: (1) Holds a baccalaureate or higher degree in any field from a regionally accredited institution of higher education; (2) has graduated from an accredited physician assistant program; (3) has passed the certification examination of the national commission; (4) has satisfied the mandatory continuing medical education requirements of the national commission for current certification by such commission and has passed any examination or continued competency assessment the passage of which may be required by the national commission for maintenance of current certification by such commission; and (5) has completed not less than sixty hours of didactic instruction in pharmacology for physician assistant practice approved by the department.
(b) The department may issue a temporary permit to an applicant who (1) is a graduate of an accredited physician assistant program; (2) has completed not less than sixty hours of didactic instruction in pharmacology for physician assistant practice approved by the department; and (3) if applying for such permit on and after September 30, 1991, holds a baccalaureate or higher degree in any field from a regionally accredited institution of higher education. Such temporary permit shall authorize the holder to practice as a physician assistant only in those settings where the supervising physician is physically present on the premises and is immediately available to the physician assistant when needed, but shall not authorize the holder to prescribe or dispense drugs. Such temporary permit shall be valid for a period not to exceed one hundred twenty calendar days after the date of graduation and shall not be renewable. Such permit shall become void and shall not be reissued in the event that the applicant fails to pass a certification examination scheduled by the national commission following the applicant's graduation from an accredited physician assistant program. Violation of the restrictions on practice set forth in this subsection may constitute a basis for denial of licensure as a physician assistant.
(c) No license or temporary permit shall be issued under this section to any applicant against whom professional disciplinary action is pending or who is the subject of an unresolved complaint.
(d) No person shall practice as a physician assistant or represent himself as a physician assistant unless he holds a license or temporary permit pursuant to this section or training permit issued pursuant to section 20-12h.
(e) Any person, except a licensed physician assistant or a physician licensed to practice medicine under this chapter, who practices or attempts to practice as a physician assistant, or any person who buys, sells or fraudulently obtains any diploma or license to practice as a physician assistant, whether recorded or not, or any person who uses the title “physician assistant” or any word or title to induce the belief that he or she is practicing as a physician assistant, without complying with the provisions of this section, shall be fined not more than five hundred dollars or imprisoned not more than five years, or both. For the purposes of this section, each instance of patient contact or consultation that is in violation of any provision of this chapter shall constitute a separate offense. Failure to renew a license in a timely manner shall not constitute a violation for the purposes of this section.
(f) No fee shall be required for the issuance of a license or a temporary permit under this section.
(P.A. 90-211, S. 4, 23; P.A. 91-112, S. 1, 2; P.A. 93-296, S. 1, 10; P.A. 95-74, S. 3, 9; P.A. 04-221, S. 1; P.A. 07-252, S. 41; June Sp. Sess. P.A. 09-3, S. 183; P.A. 25-168, S. 415.)
History: P.A. 91-112 amended Subsec. (b) to extend until March 1, 1992, the deadline for physician assistants licensed pursuant to Subsec. (b) to meet continuing education requirements; P.A. 93-296 added Subsec. (b)(3) re licensure of a person with eighteen-year employment history and amended Subsec. (c)(6) to extend application date from June 30, 1992, to October 1, 1993, effective June 29, 1993 (Revisor's note: In 1995 references to “such commission” were changed editorially by the Revisors to “said commission”); P.A. 95-74 deleted former Subsecs. (b) and (c) containing obsolete provisions on temporary licenses and relettered remaining Subsecs. accordingly, amending relettered Subsec. (d) to include training permits, effective July 1, 1995; P.A. 04-221 amended Subsec. (b) by replacing former provision re period of validity of temporary permit with provision limiting duration of temporary permit to 120 days, providing that temporary permit shall not be renewable and making a conforming change; P.A. 07-252 added Subsec. (e) re penalties for unlawfully practicing or attempting to practice as a physician assistant and for fraudulent use of title “physician assistant”, effective July 1, 2007; June Sp. Sess. P.A. 09-3 amended Subsec. (a) to increase fee from $150 to $190 and Subsec. (b) to increase fee from $75 to $150; P.A. 25-168 amended Subsecs. (a) and (b) to delete license and temporary permit issuance fees and added new Subsec. (c) re no fee required for such issuances (Revisor's note: The omission of existing Subsecs. (c) to (e) were treated as a clerical error and new Subsec. (c) was codified by the Revisors as Subsec. (f)).
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Sec. 20-12l. PA Licensure Compact. The Physician Assistant Licensure Compact, hereinafter referred to as the “PA Licensure Compact”, is hereby enacted into law and entered into by the state of Connecticut with any and all states legally joining therein in accordance with its terms. The compact is substantially as follows:
In order to strengthen access to medical services and in recognition of the advances in the delivery of medical services, the participating states of the PA Licensure Compact have allied in common purpose to develop a comprehensive process that complements the existing authority of state licensing boards to license and discipline PAs and seeks to enhance the portability of a license to practice as a PA while safeguarding the safety of patients. The compact allows medical services to be provided by PAs, via the mutual recognition of the licensee's qualifying license by other compact participating states. The compact adopts the prevailing standard for PA licensure and affirms that the practice and delivery of medical services by the PA occurs where the patient is located at the time of the patient encounter and requires the PA to be under the jurisdiction of the state licensing board where the patient is located. Each state licensing board that participates in the compact shall retain the jurisdiction to impose adverse action against a compact privilege in such board's state that was issued to a PA through the procedures of the compact. The PA Licensure Compact will alleviate burdens for military families by allowing active duty military personnel and their spouses to obtain a compact privilege based on having an unrestricted license in good standing from a participating state.
As used in the compact:
(1) “Adverse action” means any administrative, civil, equitable or criminal action permitted by a state's laws that is imposed by a licensing board or other authority against a PA license, PA license application or compact privilege, including, but not limited to, license denial, censure, revocation, suspension, probation, monitoring of the licensee or restriction on the licensee's practice.
(2) “Compact privilege” means the authorization granted by a remote state to allow a licensee from another participating state to practice as a PA to provide medical services and other licensed activity to a patient located in the remote state under the remote state's laws and regulations.
(3) “Conviction” means a finding by a court that an individual is guilty of a felony or misdemeanor offense through adjudication or entry of a plea of guilt or no contest to the charge by the offender.
(4) “Criminal background check” means the submission of fingerprints or other biometric-based information for a license applicant for the purpose of obtaining such applicant's criminal history record information, as defined in 28 CFR 20.3(d), as amended from time to time, from the state's criminal history record repository, as defined in 28 CFR 20.3(f), as amended from time to time.
(5) “Data system” means the repository of information about licensees, including, but not limited to, license status and adverse actions, that is created and administered under the terms of the compact.
(6) “Executive committee” means a group of directors and ex-officio individuals elected or appointed pursuant to subdivision (2) of subsection (f) of section 7 of the compact.
(7) “Impaired practitioner” means a PA whose practice is adversely affected by a health-related condition that impacts the PA's ability to practice.
(8) “Investigative information” means information, records or documents received or generated by a licensing board pursuant to an investigation.
(9) “Jurisprudence requirement” means the assessment of an individual's knowledge of the laws and rules governing the practice of a PA in a state.
(10) “License” means current authorization by a state, other than authorization pursuant to a compact privilege, for a PA to provide medical services that would be unlawful without such current authorization.
(11) “Licensee” means an individual who holds a license from a state to provide medical services as a PA.
(12) “Licensing board” means any state entity authorized to license and otherwise regulate PAs.
(13) “Medical services” means health care services provided for the diagnosis, prevention, treatment, cure or relief of a health condition, injury or disease, as defined by a state's laws and regulations.
(14) “Model compact” means the model for the PA Licensure Compact on file with the Council of State Governments, or other entity as designated by the commission.
(15) “Participating state” means a state that has enacted the compact.
(16) “PA” means an individual who is licensed as a physician assistant in a state. For purposes of the compact, any other title or status adopted by a state to replace the term “physician assistant” shall be deemed synonymous with “physician assistant” and “PA” and shall confer the same rights and responsibilities to the licensee under the provisions of the compact at the time of the compact's enactment.
(17) “PA Licensure Compact Commission”, “compact commission” or “commission” means the national administrative body created pursuant to subsection (a) of section 7 of the compact.
(18) “Qualifying license” means an unrestricted license issued by a participating state to provide medical services as a PA.
(19) “Remote state” means a participating state where a licensee who is not licensed as a PA is exercising or seeking to exercise the compact privilege.
(20) “Rule” means a regulation promulgated by an entity that has the force and effect of law.
(21) “Significant investigative information” means investigative information that a licensing board, after an inquiry or investigation that includes notification and an opportunity for the PA to respond if required by state law, has reason to believe is not groundless and, if proven true, would indicate more than a minor infraction.
(22) “State” means any state, commonwealth, district or territory of the United States.
(a) To participate in the compact, a participating state shall:
(1) License PAs.
(2) Participate in the compact commission's data system.
(3) Have a mechanism in place for receiving and investigating complaints against licensees and license applicants.
(4) Notify the commission, in compliance with the terms of the compact and commission rules, of any adverse action against a licensee or license applicant and the existence of significant investigative information regarding a licensee or license applicant.
(5) Fully implement a criminal background check requirement, within a time frame established by commission rule, by the participating state's licensing board receiving the results of a criminal background check and reporting to the commission whether the license applicant has been granted a license.
(6) Comply with the rules of the compact commission.
(7) Utilize passage of a recognized national licensure examination, including, but not limited to, the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants, as a requirement for PA licensure.
(8) Grant the compact privilege to a holder of a qualifying license in a participating state.
(b) Nothing in the compact shall be construed to prohibit a participating state from charging a fee for granting the compact privilege.
(a) To exercise the compact privilege, a licensee shall:
(1) Have graduated from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or any other PA program authorized by commission rule.
(2) Hold current certification from the National Commission on Certification of Physician Assistants.
(3) Have no felony or misdemeanor convictions.
(4) Have never had a controlled substance license, permit or registration suspended or revoked by a state or by the United States Drug Enforcement Administration.
(5) Have a unique identifier as determined by commission rule.
(6) Hold a qualifying license.
(7) Have had no revocation of a license or limitation or restriction on any license currently held or compact privilege due to an adverse action, provided (A) if a licensee had a limitation or restriction on a license or compact privilege due to an adverse action, two years shall have elapsed from the date on which the license or compact privilege is no longer limited or restricted due to the adverse action, and (B) if a compact privilege has been revoked or is limited or restricted in a participating state for conduct that would not be a basis for disciplinary action in a participating state in which the licensee is practicing or applying to practice under a compact privilege, such participating state shall have the discretion not to consider such action as an adverse action requiring the denial or removal of a compact privilege in such state.
(8) Notify the compact commission that the licensee is seeking the compact privilege in a remote state.
(9) Meet any jurisprudence requirement of a remote state in which the licensee is seeking to practice under the compact privilege and pay any fees applicable to satisfying the jurisprudence requirement.
(10) Report to the commission any adverse action taken by a nonparticipating state not later than thirty days after the adverse action was taken.
(b) The compact privilege shall be valid until the expiration or revocation of the qualifying license unless terminated pursuant to an adverse action. The licensee shall comply with all of the requirements of subsection (a) of this section of the compact to maintain the compact privilege in a remote state. If the participating state takes adverse action against a qualifying license, the licensee shall lose the compact privilege in any remote state in which the licensee has a compact privilege until both of the following occur:
(1) The license is no longer limited or restricted; and
(2) Two years have elapsed from the date on which the license is no longer limited or restricted due to the adverse action.
(c) Once a restricted or limited license satisfies the requirements of subdivisions (1) and (2) of subsection (b) of this section of the compact, the licensee shall meet the requirements of subsection (a) of this section of the compact to obtain a compact privilege in any remote state.
(d) For each remote state in which a PA seeks authority to prescribe controlled substances, the PA shall satisfy all requirements imposed by such state in granting or renewing such authority.
Upon a licensee's application for a compact privilege, the licensee shall identify to the commission the participating state from which the licensee is applying, in accordance with applicable rules adopted by the commission, and subject to the following requirements:
(1) When applying for a compact privilege, the licensee shall (A) provide the commission with the address of the licensee's primary residence, and (B) report to the commission any change in the address of the licensee's primary residence immediately following such change.
(2) When applying for a compact privilege, the licensee shall be required to consent to accept service of process by mail at the licensee's primary residence on file with the commission with respect to any action brought against the licensee by the commission or a participating state, including, but not limited to, a subpoena.
(a) A participating state in which a licensee is licensed shall have exclusive power to impose adverse action against the qualifying license issued by such participating state.
(b) In addition to the other powers conferred by state law, a remote state shall have the authority, in accordance with existing state due process requirements, to do all of the following:
(1) Take adverse action against a PA's compact privilege in such remote state to remove a licensee's compact privilege or take other action necessary under applicable law to protect the health and safety of its citizens.
(2) Issue subpoenas for hearings or investigations that require the attendance and testimony of witnesses and for the production of evidence. Any subpoena issued by a licensing board in a participating state for the attendance and testimony of witnesses or the production of evidence from another participating state shall be enforced in such other participating state by any court of competent jurisdiction according to the practice and procedure of such court applicable to subpoenas issued in proceedings pending before such court. The issuing authority shall pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state in which the witnesses or evidence is located. Notwithstanding the provisions of this subdivision, a participating state shall not issue a subpoena to gather evidence of conduct in another state that is lawful in such other state for the purpose of taking adverse action against a licensee's compact privilege or application for a compact privilege in such participating state.
(c) Nothing in the compact shall be construed to authorize a participating state to impose discipline against a PA's compact privilege or deny an application for a compact privilege in such participating state for the PA's otherwise lawful practice in another state.
(d) For purposes of taking adverse action, the participating state that issued the qualifying license shall give the same priority and effect to reported conduct received from any other participating state as it would if the conduct had occurred within the participating state that issued the qualifying license and shall apply its own state laws to determine appropriate action.
(e) A participating state, if otherwise permitted by state law, may recover from the affected PA the costs of any investigation or disposition of a case resulting from any adverse action taken against such PA.
(f) A participating state may take adverse action based on the factual findings of a remote state, provided the participating state follows its own procedures for taking the adverse action.
(g) Joint Investigations
(1) In addition to the authority granted to a participating state by its respective state statutes and regulations concerning PAs, or other applicable state law, any participating state may participate with any other participating state in a joint investigation of a licensee.
(2) A participating state shall share any investigative, litigation or compliance materials in furtherance of any joint or individual investigation initiated under the compact.
(h) If an adverse action is taken against a PA's qualifying license, the PA's compact privilege in all remote states shall be deactivated until two years have elapsed from the date on which all restrictions were removed from the state license. All disciplinary orders by the participating state that issued the qualifying license that impose one or more adverse actions against a PA's license shall include a statement that the PA's compact privilege is deactivated in all participating states during the pendency of the order.
(i) If any participating state takes adverse action, it shall promptly notify the administrator of the data system.
(a) The participating states hereby create and establish a joint government agency and national administrative body known as the PA Licensure Compact Commission. The commission shall be an instrumentality of the compact states acting jointly and not an instrumentality of any one state. The commission shall come into existence on or after the effective date of the compact as set forth in subsection (a) of section 11 of the compact.
(b) Membership, Voting and Meetings
(1) Each participating state shall have and be limited to one delegate selected by such participating state's licensing board or, if the state has more than one licensing board, selected collectively by the participating state's licensing boards.
(2) The delegate shall be either:
(A) A current PA, physician or public member of a licensing board or a PA council or committee; or
(B) An administrator of a licensing board.
(3) Any delegate may be removed or suspended from office as provided by the laws of the state from which the delegate is appointed.
(4) The participating state licensing board shall fill any vacancy occurring in the commission not later than sixty days after the date on which the vacancy occurred.
(5) Each delegate shall be entitled to one vote on all matters voted on by the commission and shall otherwise have an opportunity to participate in the business and affairs of the commission. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates' participation in meetings by telecommunications, video conference or other means of communication.
(6) The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the compact and the bylaws.
(7) The commission shall establish by rule a term of office for delegates.
(c) The commission shall have the following powers and duties:
(1) Establish a code of ethics for the commission;
(2) Establish the fiscal year of the commission;
(3) Establish fees;
(4) Establish bylaws;
(5) Maintain its financial records in accordance with the bylaws;
(6) Meet and take such actions as are consistent with the provisions of the compact and the bylaws;
(7) Promulgate rules to facilitate and coordinate implementation and administration of the compact. The rules shall have the force and effect of law and shall be binding in all participating states;
(8) Bring and prosecute legal proceedings or actions in the name of the commission, provided the standing of any state licensing board to sue or be sued under applicable law shall not be affected;
(9) Purchase and maintain insurance and bonds;
(10) Borrow, accept or contract for services of personnel, including, but not limited to, employees of a participating state;
(11) Hire employees and engage contractors, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the compact and establish the commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel and other related personnel matters;
(12) Accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and receive, utilize and dispose of such money, equipment, supplies material and services, provided the commission shall avoid any appearance of impropriety or conflict of interest at all times;
(13) Lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold, improve or use, any property, real, personal or mixed, provided the commission shall avoid any appearance of impropriety at all times;
(14) Sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property real, personal or mixed;
(15) Establish a budget and make expenditures;
(16) Borrow money;
(17) Appoint committees, including standing committees composed of members, state regulators, state legislators or their representatives and consumer representatives, and such other interested persons as may be designated in the compact and the bylaws;
(18) Provide and receive information from, and cooperate with, law enforcement agencies;
(19) Elect a chair, vice chair, secretary and treasurer and such other officers of the commission as provided in the commission's bylaws;
(20) Reserve for itself, in addition to those reserved exclusively to the commission under the compact, powers that the executive committee may not exercise;
(21) Approve or disapprove a state's participation in the compact based upon its determination as to whether the state's compact legislation departs in a material manner from the model compact language;
(22) Prepare and provide to the participating states an annual report; and
(23) Perform such other functions as may be necessary or appropriate to achieve the purposes of the compact consistent with the state regulation of PA licensure and practice.
(d) Meetings of the Commission
(1) All meetings of the commission that are not closed pursuant to subdivision (3) of this subsection shall be open to the public. Notice of public meetings shall be posted on the commission's Internet web site not later than thirty days prior to the public meeting.
(2) Notwithstanding the provisions of subdivision (1) of this subsection, the commission may convene a public meeting by providing notice of the meeting at least twenty-four hours prior to the meeting on the commission's Internet web site, and any other means as provided in the commission's rules, for any of the reasons it may dispense with notice of proposed rulemaking under subsection (l) of section 9 of the compact.
(3) The commission may convene in a closed, nonpublic meeting or nonpublic part of a public meeting to receive legal advice or to discuss:
(A) Noncompliance of a participating state with its obligations under the compact;
(B) The employment, compensation, discipline or other matters, practices or procedures related to specific employees or other matters related to the commission's internal personnel practices and procedures;
(C) Current, threatened or reasonably anticipated litigation;
(D) Negotiation of contracts for the purchase, lease or sale of goods, services or real estate;
(E) Accusing any person of a crime or formally censuring any person;
(F) Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
(G) Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
(H) Disclosure of investigative records compiled for law enforcement purposes;
(I) Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the compact;
(J) Legal advice; or
(K) Matters specifically exempted from disclosure by federal or participating states' statutes.
(4) If a meeting, or portion of a meeting, is closed pursuant to subdivision (3) of this subsection, the chair of the meeting, or the chair's designee, shall certify that the meeting or portion of the meeting may be closed and shall reference each relevant exempting provision.
(5) The commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including, but not limited to, a description of the views expressed at the meeting. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the commission or order of a court of competent jurisdiction.
(e) Financing of the Commission
(1) The commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities.
(2) The commission may accept any and all appropriate revenue sources, donations and grants of money, equipment, supplies, materials and services.
(3) The commission may levy on and collect an annual assessment from each participating state and may impose compact privilege fees on licensees of participating states to whom a compact privilege is granted to cover the cost of the operations and activities of the commission and its staff. Such fees shall be in a total amount that is sufficient to cover its annual budget as approved by the commission each year for which revenue is not provided by other sources. The aggregate annual assessment amount levied on participating states shall be allocated based upon a formula to be determined by commission rule.
(A) A compact privilege expires when the licensee's qualifying license in the participating state from which the licensee applied for the compact privilege expires.
(B) If the licensee terminates the qualifying license through which the licensee applied for the compact privilege before its scheduled expiration and the licensee has a qualifying license in another participating state, the licensee shall inform the commission that it is changing to such participating state the participating state through which it applies for a compact privilege and pay to the commission any compact privilege fee required by commission rule.
(4) The commission shall not (A) incur an obligation of any kind prior to securing the funds adequate to meet the same, or (B) pledge the credit of any of the participating states, except by and with the authority of the participating state.
(5) The commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the commission shall be subject to the financial review and accounting procedures established under its bylaws. All receipts and disbursements of funds handled by the commission shall be subject to an annual financial review by a certified or licensed public accountant, and the report of the financial review shall be included in and become part of the annual report of the commission.
(f) The Executive Committee
(1) The executive committee shall have the power to act on behalf of the commission according to the terms of the compact and commission rules.
(2) The executive committee shall be composed of the following nine members:
(A) Seven voting members who shall be elected by the commission from the current membership of the commission;
(B) One ex-officio, nonvoting member from a recognized national PA professional association; and
(C) One ex-officio, nonvoting member from a recognized national PA certification organization.
(3) The ex-officio members shall be selected by their respective organizations.
(4) The commission may remove any member of the executive committee as provided in its bylaws.
(5) The executive committee shall meet at least annually.
(6) The executive committee shall have the following duties and responsibilities:
(A) Recommend to the commission changes to the commission's rules or bylaws, changes to the compact legislation, fees to be paid by compact participating states, including, but not limited to, annual dues, and any commission compact fee charged to licensees for the compact privilege;
(B) Ensure compact administration services are appropriately provided, contractual or otherwise;
(C) Prepare and recommend the budget;
(D) Maintain financial records on behalf of the commission;
(E) Monitor compact compliance of participating states and provide compliance reports to the commission;
(F) Establish additional committees as necessary;
(G) Exercise the powers and duties of the commission during the interim between commission meetings, except the issuance of proposed rulemaking, the adoption of commission rules or bylaws or the exercise of any other powers and duties exclusively reserved to the commission by the commission's rules; and
(H) Perform other duties as provided in the commission's rules or bylaws.
(7) All meetings of the executive committee at which it votes or plans to vote on matters in exercising the powers and duties of the commission shall be open to the public and public notice of such meetings shall be given as public meetings of the commission are given.
(8) The executive committee may convene in a closed, nonpublic meeting for the same reasons that the commission may convene in a nonpublic meeting as set forth in subdivision (3) of subsection (d) of this section of the compact and shall announce the closed meeting as the commission is required to under subdivision (4) of subsection (d) of this section of the compact and keep minutes of the closed meeting as the commission is required to under subdivision (5) of subsection (d) of this section of the compact.
(g) Qualified Immunity, Defense and Indemnification
(1) The members, officers, executive director, employees and representatives of the commission shall be immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred, within the scope of commission employment, duties or responsibilities, provided nothing in this subdivision shall be construed to protect any such person from suit or liability for any damage, loss, injury or liability caused by the intentional or wilful or wanton misconduct of that person. The procurement of insurance of any type by the commission shall not in any way compromise or limit the immunity granted under this subdivision.
(2) The commission shall defend any member, officer, executive director, employee and representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error or omission that occurred within the scope of commission employment, duties or responsibilities, or as determined by the commission that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities, provided (A) nothing in this subdivision shall be construed to prohibit such person from retaining such person's own counsel at such person's own expense, and (B) the actual or alleged act, error or omission did not result from such person's intentional or wilful or wanton misconduct.
(3) The commission shall indemnify and hold harmless any member, officer, executive director, employee or representative of the commission for the amount of any settlement or judgment obtained against such person arising out of any actual or alleged act, error or omission that occurred within the scope of commission employment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities, provided the actual or alleged act, error or omission did not result from the intentional or wilful or wanton misconduct of such person.
(4) Venue shall be proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses in any proceedings as authorized by commission rules.
(5) Nothing in the compact shall be construed as a limitation on the liability of any licensee for professional malpractice or misconduct, which shall be governed solely by any other applicable state laws.
(6) Nothing in the compact shall be construed to designate the venue or jurisdiction to bring actions for alleged acts of malpractice, professional misconduct, negligence or other such civil action pertaining to the practice of a PA. All such matters shall be determined exclusively by state law other than the compact.
(7) Nothing in the compact shall be construed to waive or otherwise abrogate a participating state's state action immunity or state action affirmative defense with respect to antitrust claims under the Sherman Act, 15 USC 1 et seq., as amended from time to time, Clayton Antitrust Act, 15 USC 12-27, as amended from time to time, or any other state or federal antitrust or anticompetitive law or regulation.
(8) Nothing in the compact shall be construed to be a waiver of sovereign immunity by the participating states or by the commission.
(a) The commission shall provide for the development, maintenance, operation and utilization of a coordinated data and reporting system containing licensure, adverse action and the reporting of the existence of significant investigative information on all licensed PAs and applicants denied a license in participating states.
(b) Notwithstanding any other state law, each participating state shall submit a uniform data set to the data system, utilizing a unique identifier for such state, on all PAs to whom the compact is applicable as required by the rules of the commission, including the following:
(1) Identifying information;
(2) Licensure data;
(3) Adverse actions against a license or compact privilege;
(4) Any denial of application for licensure, except any criminal history record information where the reporting of such information is prohibited by law, and the reason or reasons for such denial;
(5) The existence of significant investigative information; and
(6) Any other information that may facilitate the administration of the compact, as determined by the rules of the commission.
(c) Significant investigative information pertaining to a licensee in any participating state shall only be available to other participating states.
(d) The commission shall promptly notify all participating states of any adverse action taken against a licensee or an individual applying for a license that has been reported to the commission. Such adverse action information shall be available to any other participating state.
(e) Each participating state contributing information to the data system may, in accordance with state or federal law, designate information that may not be shared with the public without the express permission of the contributing state. Notwithstanding any such designation, such information shall be reported to the commission through the data system.
(f) Any information submitted to the data system that is subsequently expunged pursuant to federal law or the laws of the participating state contributing the information shall be removed from the data system upon the reporting of such expungement by the participating state to the commission.
(g) The records and information provided to a participating state pursuant to the compact or through the data system, when certified by the commission or an agent thereof, shall constitute the authenticated business records of the commission and shall be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial or administrative proceedings in a participating state.
(a) The commission shall exercise its rulemaking powers pursuant to the criteria set forth in this section of the compact and the rules adopted under the compact. A commission rule shall become binding as of the date specified by the commission for each rule.
(b) The commission shall promulgate reasonable rules to effectively and efficiently implement and administer the compact and achieve the compact's purposes. A commission rule shall be invalid and have no force or effect only if a court of competent jurisdiction holds that the rule is invalid because the commission exercised its rulemaking authority in a manner that is beyond the scope of the purposes of the compact, or the powers granted under the compact, or based upon another applicable standard of review.
(c) The rules of the commission shall have the force of law in each participating state, provided where the rules of the commission conflict with the laws of the participating state that establish the medical services a PA may perform in the participating state, as held by a court of competent jurisdiction, the rules of the commission shall be ineffective in such state to the extent of the conflict.
(d) If a majority of the legislatures of the participating states rejects a commission rule by enactment of a statute or resolution in the same manner used to adopt the compact not later than four years after the date of adoption of the commission rule, such rule shall have no further force and effect in any participating state or to any state applying to participate in the compact.
(e) Commission rules shall be adopted at a regular or special meeting of the commission.
(f) Prior to promulgation and adoption of a final rule or rules by the commission, and at least thirty days prior to the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rulemaking:
(1) On the Internet web site of the commission or other publicly accessible platform;
(2) To persons who have requested notice of the commission's notices of proposed rulemaking; and
(3) In such other manners as the commission may by rule specify.
(g) The notice of proposed rulemaking shall include the following:
(1) The time, date and location of the public hearing on the proposed rule and the proposed time, date and location of the meeting in which the proposed rule will be considered and voted upon;
(2) The text of the proposed rule and the reason for the proposed rule;
(3) A request for comments on the proposed rule from any interested person and the date by which written comments must be received; and
(4) The manner in which interested persons may submit notice to the commission of their intention to attend the public hearing or provide any written comments.
(h) Prior to adoption of a proposed rule, the commission shall allow persons to submit written data, facts, opinions and arguments, which shall be made available to the public.
(i) If the hearing is to be held via electronic means, the commission shall publish the mechanism for access to the electronic hearing.
(1) All persons wishing to be heard at the hearing shall, as directed in the notice of proposed rulemaking, notify the commission of their desire to appear and testify at the hearing not less than five business days prior to the scheduled date of the hearing.
(2) Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.
(3) All hearings shall be recorded. A copy of the recording and the written comments, data, facts, opinions and arguments received in response to the proposed rulemaking shall be made available to a person upon request.
(4) Nothing in this section of the compact shall be construed to require a separate hearing on each proposed rule. Proposed rules may be grouped for the convenience of the commission at hearings required by this section of the compact.
(j) Following the public hearing, the commission shall consider all written and oral comments timely received.
(k) The commission shall, by majority vote of all delegates, take final action on the proposed rule and determine the effective date of the rule, if adopted, based on the rulemaking record and the full text of the rule.
(1) If adopted, the rule shall be posted on the commission's Internet web site.
(2) The commission may adopt changes to the proposed rule, provided the changes do not expand the original purpose of the proposed rule.
(3) The commission shall post on its Internet web site an explanation of the reasons for substantive changes made to the proposed rule and the reasons for any substantive changes that were recommended by commenters but not made.
(4) The commission shall determine a reasonable effective date for the rule. Except for an emergency as provided in subsection (l) of this section of the compact, the effective date of the rule shall be no sooner than thirty days after the commission issued the notice that it adopted the rule.
(l) Upon determination that an emergency exists, the commission may consider and adopt an emergency rule with twenty-four hours' prior notice, without the opportunity for comment or hearing, provided the usual rulemaking procedures provided in the compact and in this section of the compact shall be retroactively applied to the rule as soon as reasonably possible, but in no event later than ninety days after the effective date of the rule. For the purposes of this subsection, “emergency rule” means a rule that shall be adopted immediately by the commission to:
(1) Meet an imminent threat to public health, safety or welfare;
(2) Prevent a loss of commission or participating state funds;
(3) Meet a deadline for the promulgation of a commission rule that is established by federal law or rule; or
(4) Protect public health or safety.
(m) The commission or an authorized committee of the commission may direct revisions to a previously adopted commission rule for purposes of correcting typographical errors, errors in format, errors in consistency or grammatical errors. Public notice of any revisions shall be posted on the Internet web site of the commission. The revision shall be subject to challenge by any person for a period of thirty days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made as set forth in the notice of revisions and delivered to the commission prior to the end of the notice period. If no challenge is made, the revision shall take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the commission.
(n) No participating state's rulemaking requirements shall apply under the compact.
(a) Oversight
(1) The executive and judicial branches of state government in each participating state shall enforce the compact and take all actions necessary and appropriate to implement the compact.
(2) Venue shall be proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. The commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. Nothing in this subdivision shall be construed to affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice, misconduct or any such similar matter.
(3) The commission shall be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the compact or the commission's rules and shall have standing to intervene in such a proceeding for all purposes. Failure to provide the commission with service of process shall render a judgment or order in such proceeding void as to the commission, the compact or commission rules.
(b) Default, Technical Assistance and Termination
(1) If the commission determines that a participating state has defaulted in the performance of its obligations or responsibilities under the compact or the commission rules, the commission shall provide written notice to the defaulting state and other participating states. The notice shall describe the default, the proposed means of curing the default and any other action that the commission may take and shall offer remedial training and specific technical assistance regarding the default.
(2) If a state in default fails to cure the default, the defaulting state may be terminated from the compact upon an affirmative vote of a majority of the delegates of the participating states, and all rights, privileges and benefits conferred by the compact upon such state may be terminated on the effective date of termination. A cure of the default shall not relieve the offending state of obligations or liabilities incurred during the period of default.
(3) Termination of participation in the compact shall be imposed only after all other means of securing compliance have been exhausted. The commission shall provide notice of intent to suspend or terminate to the governor and majority and minority leaders of the defaulting state's legislature and the licensing board or boards of each of the participating states.
(4) A state that has been terminated shall be responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including, but not limited to, obligations that extend beyond the effective date of termination.
(5) The commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the compact, unless agreed upon in writing between the commission and the defaulting state.
(6) The defaulting state may appeal its termination from the compact by the commission by petitioning the United States District Court for the District of Columbia or the federal district where the commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including, but not limited to, reasonable attorney's fees.
(7) Upon the termination of a state's participation in the compact, the state shall immediately provide notice to all licensees within such state of such termination.
(A) Licensees who have been granted a compact privilege in such state shall retain the compact privilege for one hundred eighty days following the effective date of such termination.
(B) Licensees who are licensed in such state who have been granted a compact privilege in a participating state shall retain the compact privilege for one hundred eighty days unless the licensee also has a qualifying license in a participating state or obtains a qualifying license in a participating state before the one-hundred-eighty-day period ends, in which case the compact privilege shall continue.
(c) Dispute Resolution
(1) Upon request by a participating state, the commission shall attempt to resolve disputes related to the compact that arise among participating states and between participating and nonparticipating states.
(2) The commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
(d) Enforcement
(1) The commission, in the reasonable exercise of its discretion, shall enforce the provisions of the compact and rules of the commission.
(2) If compliance is not secured after all means to secure compliance have been exhausted, the commission may, by majority vote, initiate legal action in the United States District Court for the District of Columbia, or the federal district where the commission has its principal offices, against a participating state in default to enforce compliance with the provisions of the compact and the commission's promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. If judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney's fees.
(3) The remedies set forth in subdivision (2) of this subsection shall not be the exclusive remedies of the commission. The commission may pursue any other remedies available under federal or state law.
(e) Legal Action Against the Commission
(1) A participating state may initiate legal action against the commission in the United States District Court for the District of Columbia, or the federal district where the commission has its principal offices, to enforce compliance with the provisions of the compact and its rules. The relief sought may include both injunctive relief and damages. If judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorney's fees.
(2) No person other than a participating state shall enforce the compact against the commission.
(a) The compact shall come into effect on the date on which this compact statute is enacted into law in the seventh participating state.
(1) On or after the effective date of the compact, the commission shall convene and review the enactment of each of the states that enacted the compact prior to the commission convening, which shall be known as the charter participating states, to determine if the statute enacted by each such charter participating state is materially different from the compact.
(A) A charter participating state whose enactment is found to be materially different from the compact shall be entitled to the default process set forth in subsection (b) of section 10 of the compact.
(B) If any participating state later withdraws from the compact or its participation is terminated, the commission shall remain in existence and the compact shall remain in effect even if the number of participating states is less than seven after such withdrawal. Participating states enacting the compact subsequent to the commission convening shall be subject to the process set forth in subdivision (21) of subsection (c) of section 7 of the compact to determine if such enactments are materially different from the compact and whether such participating states qualify for participation in the compact.
(2) Participating states enacting the compact subsequent to the seven initial charter participating states shall be subject to the process set forth in subdivision (21) of subsection (c) of section 7 of the compact to determine if such enactments are materially different from the compact and whether such participating states qualify for participation in the compact.
(3) All actions taken for the benefit of the commission or in furtherance of the purposes of the administration of the compact prior to the effective date of the compact or the commission coming into existence shall be considered to be actions of the commission unless specifically repudiated by the commission.
(b) Any state that joins the compact shall be subject to the commission's rules and bylaws as such rules and bylaws exist on the date on which the compact becomes law in such state. Any rule that has been previously adopted by the commission shall have the full force and effect of law on the day the compact becomes law in such state.
(c) Any participating state may withdraw from the compact by enacting a statute repealing the compact.
(1) A participating state's withdrawal from the compact shall not take effect until one hundred eighty days after enactment of the repealing statute. During such one-hundred-eighty-day period, all compact privileges that were in effect in the withdrawing state and were granted to licensees licensed in the withdrawing state shall remain in effect. If any licensee licensed in the withdrawing state is also licensed in another participating state or obtains a license in another participating state on or before one hundred eighty days after such withdrawal, the licensee's compact privileges in other participating states shall not be affected by the passage of such one hundred eighty days.
(2) Withdrawal under subsection (d) of this section of the compact shall not affect the continuing requirement of the state licensing board or boards of the withdrawing state to comply with the investigative and adverse action reporting requirements of the compact prior to the effective date of withdrawal.
(3) Upon the enactment of a statute withdrawing a state from the compact, the state shall immediately provide notice of such withdrawal to all licensees in such state. Such withdrawing state shall continue to recognize all licenses granted pursuant to the compact for a minimum of one hundred eighty days after the date of such notice of withdrawal.
(d) Nothing in the compact shall be construed to invalidate or prevent any PA licensure agreement or other cooperative arrangement between participating states and between a participating state and nonparticipating state that does not conflict with the provisions of the compact.
(e) The compact may be amended by the participating states. No amendment to the compact shall become effective and binding upon any participating state until it is enacted materially in the same manner into the laws of all participating states as determined by the commission.
(a) The compact and the commission's rulemaking authority shall be liberally construed to effectuate the purposes and the implementation and administration of the compact. Provisions of the compact expressly authorizing or requiring the promulgation of rules shall not be construed to limit the commission's rulemaking authority solely for those purposes.
(b) The provisions of the compact shall be severable and if any phrase, clause, sentence or provision of the compact is held by a court of competent jurisdiction to be contrary to the constitution of any participating state, a state seeking participation in the compact or of the United States, or the applicability of the compact to any government, agency, person or circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of the compact and the applicability thereof to any other government, agency, person or circumstance shall not be affected thereby.
(c) Notwithstanding the provisions of subsection (b) of this section of the compact, the commission may deny a state's participation in the compact or, in accordance with the requirements of subsection (b) of section 10 of the compact, terminate a participating state's participation in the compact if it determines that a constitutional requirement of a participating state is, or would be with respect to a state seeking to participate in the compact, a material departure from the compact. Otherwise, if the compact is held to be contrary to the constitution of any participating state, the compact shall remain in full force and effect as to the remaining participating states and in full force and effect as to the participating state affected as to all severable matters.
(a) Nothing in the compact shall prevent the enforcement of any other law of a participating state that is not inconsistent with the compact.
(b) Any laws in a participating state in conflict with the compact are superseded to the extent of the conflict.
(c) All agreements between the commission and the participating states are binding in accordance with the terms of such agreements.
(P.A. 25-168, S. 457.)
History: P.A. 25-168 effective July 1, 2025.
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Sec. 20-12m. State and national fingerprint-based criminal history records check of persons applying for licensure as a physician assistant. The Commissioner of Public Health shall require each person applying for licensure as a physician assistant to submit to a state and national fingerprint-based criminal history records check pursuant to section 29-17a. As used in this section, (1) “physician assistant” means an individual licensed to practice as a physician assistant, and (2) “licensure” means authorization by a state physician assistant regulatory authority to practice as a physician assistant, the practice of which would be unlawful without such authorization.
(P.A. 25-168, S. 458.)
History: P.A. 25-168 effective July 1, 2025.
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Sec. 20-14h. Definitions. As used in sections 20-14h to 20-14j, inclusive:
(1) “Administration” means the direct application of a medication by means other than injection to the body of a person but does not mean the administration of epinephrine or insulin by auto injector to a person residing in a facility licensed or certified by the Department of Developmental Services to treat an acute allergic reaction or diabetes.
(2) “Day programs”, “residential facilities” and “individual and family support” include only those programs, facilities and support services designated in the regulations adopted pursuant to section 20-14j.
(3) “Juvenile residential centers” include only those centers operated under the jurisdiction of the Judicial Department.
(4) “Medication” means any medicinal preparation, and includes any controlled substances specifically designated in the regulations or policies adopted pursuant to section 20-14j.
(5) “Trained person” means a person who has successfully completed training prescribed by the regulations or policies adopted pursuant to section 20-14j.
(P.A. 87-433, S. 1, 4; P.A. 90-70, S. 1, 4; P.A. 05-150, S. 1; P.A. 21-104, S. 12; P.A. 25-79, S. 1.)
History: P.A. 90-70 added definition of “juvenile detention centers” as Subdiv. (3), renumbering as necessary; P.A. 05-150 amended Subdiv. (2) to include reference to individual and family support; P.A. 21-104 amended Subdiv. (3) to replace “Juvenile detention centers” with “Juvenile residential centers”, effective January 1, 2022; P.A. 25-79 amended Subdiv. (1) by redefining “administration” to exclude administration of epinephrine or insulin by auto injector to person residing in facility licensed or certified by Department of Developmental Services to treat an acute allergic reaction or diabetes, effective June 23, 2025.
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Sec. 20-14i. Administration of medication by trained persons. Notwithstanding any provisions of chapter 378, said chapter shall not prohibit the administration of medication to persons (1) attending day programs, residing in residential facilities or receiving individual and family support, under the jurisdiction of the Departments of Children and Families, Correction, Developmental Services and Mental Health and Addiction Services, (2) being detained in juvenile residential centers or residing in residential facilities dually licensed by the Department of Children and Families and the Department of Public Health, (3) residing in substance abuse treatment facilities licensed by the Department of Children and Families pursuant to section 17a-145 when such medication is administered by trained persons, pursuant to the written order of a physician licensed under this chapter, a dentist licensed under chapter 379, an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a or a physician assistant licensed to prescribe in accordance with section 20-12d, authorized to prescribe such medication, or (4) residing in facilities licensed or certified by the Department of Developmental Services, provided (A) such administration of medication is performed using an auto injector and limited to the administration of epinephrine or insulin to treat an acute allergic reaction or diabetes, and (B) such administration of medication is performed by a trained person who has received specialized training in the administration of medication by auto injector, as prescribed by the Commissioner of Developmental Services. The provisions of this section shall not apply to institutions, facilities or programs licensed pursuant to chapter 368v.
(P.A. 87-433, S. 2, 4; P.A. 90-70, S. 2, 4; P.A. 93-91, S. 1, 2; P.A. 96-19, S. 2; P.A. 04-257, S. 103; P.A. 05-150, S. 2; 05-246, S. 14; P.A. 07-73, S. 2(a); P.A. 09-197, S. 2; P.A. 21-104, S. 13; P.A. 25-79, S. 2.)
History: P.A. 90-70 added phrase “or being detained in juvenile detention centers”; P.A. 93-91 substituted commissioner and department of children and families for commissioner and department of children and youth services, effective July 1, 1993; P.A. 96-19 expanded written orders by physicians to include written orders by advanced practice registered nurses and physician assistants; P.A. 04-257 made a technical change, effective June 14, 2004; P.A. 05-150 added reference to persons receiving individual and family support; P.A. 05-246 added exception for persons residing in residential facilities dually licensed by the Departments of Children and Families and Public Health; pursuant to P.A. 07-73 “Department of Mental Retardation” was changed editorially by the Revisors to “Department of Developmental Services”, effective October 1, 2007; P.A. 09-197 designated existing provisions re persons to whom administration of medication is not prohibited by Ch. 378 as Subdivs. (1) and (2) and added Subdiv. (3) re persons residing in substance abuse treatment facilities licensed by Department of Children and Families, effective July 1, 2009; P.A. 21-104 replaced “juvenile detention centers” with “juvenile residential centers”, effective January 1, 2022; P.A. 25-79 added Subdiv. (4) re persons residing in facilities licensed or certified by Department of Developmental Services and made technical and conforming changes, effective June 23, 2025.
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Sec. 20-14o. Prescriptions for opioid drugs. (a) As used in this section:
(1) “Opioid drug” means “opioid”, as defined in 21 USC 802, as amended from time to time;
(2) “Adult” means a person who is at least eighteen years of age;
(3) “Prescribing practitioner” has the same meaning as provided in section 20-14c;
(4) “Minor” means a person who is under eighteen years of age;
(5) “Opioid agonist” means a medication that binds to the opiate receptors and provides relief to individuals in treatment for abuse of or dependence on an opioid drug;
(6) “Opiate receptor” means a specific site on a cell surface that interacts in a highly selective fashion with an opioid drug;
(7) “Palliative care” means specialized medical care to improve the quality of life of patients and their families facing the problems associated with a life-threatening illness; and
(8) “Opioid antagonist” has the same meaning as provided in section 17a-714a.
(b) When issuing a prescription for an opioid drug to an adult patient for the first time for outpatient use, a prescribing practitioner who is authorized to prescribe an opioid drug shall not issue a prescription for more than a seven-day supply of such drug, as recommended in the National Centers for Disease Control and Prevention's Guideline for Prescribing Opioids for Chronic Pain.
(c) A prescribing practitioner shall not issue a prescription for an opioid drug to a minor for more than a five-day supply of such drug.
(d) Notwithstanding the provisions of subsections (b) and (c) of this section, if, in the professional medical judgment of a prescribing practitioner, more than a seven-day supply of an opioid drug is required to treat an adult patient's acute medical condition, or more than a five-day supply of an opioid drug is required to treat a minor patient's acute medical condition, as determined by the prescribing practitioner, or is necessary for the treatment of chronic pain, pain associated with a cancer diagnosis or for palliative care, then the prescribing practitioner may issue a prescription for the quantity needed to treat the acute medical condition, chronic pain, pain associated with a cancer diagnosis or pain experienced while the patient is in palliative care. The condition triggering the prescription of an opioid drug for more than a seven-day supply for an adult patient or more than a five-day supply for a minor patient shall be documented in the patient's medical record and the practitioner shall indicate that an alternative to the opioid drug was not appropriate to address the medical condition.
(e) The provisions of subsections (b), (c) and (d) of this section shall not apply to medications designed for the treatment of abuse of or dependence on an opioid drug, including, but not limited to, opioid agonists and opioid antagonists.
(f) When issuing a prescription for an opioid drug to an adult or minor patient, the prescribing practitioner shall (1) discuss with the patient the risks associated with the use of such opioid drug, including, but not limited to, the risks of addiction and overdose associated with opioid drugs and the dangers of taking opioid drugs with alcohol, benzodiazepines and other central nervous system depressants, and the reasons the prescription is necessary, and, if applicable, with the custodial parent, guardian or other person having legal custody of the minor patient if such parent, guardian or other person is present at the time of issuance of the prescription, and (2) encourage the patient and, if applicable, the custodial parent, guardian or other person having legal custody of the minor patient if such parent, guardian or other person is present at the time of issuance of the prescription, to obtain an opioid antagonist.
(P.A. 16-43, S. 7; P.A. 17-131, S. 5; 17-188, S. 4; P.A. 23-97, S. 6; P.A. 25-101, S. 24; 25-168, S. 118.)
History: P.A. 16-43 effective July 1, 2016; P.A. 17-131 amended Subsec. (c) by replacing “seven-day” with “five-day”, deleting “at any time”, and deleting provisions re discussion of risks when issuing prescription to minor for less than seven-day supply, amended Subsec. (d) by adding “acute medical condition” and adding provisions re more than five-day supply for minor patient, and added Subsec. (f) re discussion of risks, effective July 1, 2017; P.A. 17-188 amended Subsec. (d) by making a technical change; P.A. 23-97 amended Subsec. (f) by designating existing provisions as Subdiv. (1), making a technical change and adding Subdiv. (2) requiring a practitioner to encourage patient to obtain an opioid antagonist; P.A. 25-101 amended Subsec. (a)(1) by redefining “opioid drug” to mean “opioid” as defined in 21 USC 802, effective June 24, 2025; P.A. 25-168 made an identical change as P.A. 25-101, effective June 30, 2025.
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Sec. 20-14r. Voluntary nonopioid directive form. Establishment and publication. Immunity from liability. (a) As used in this section:
(1) “Opioid drug” has the same meaning as provided in section 20-14o;
(2) “Prescribing practitioner” has the same meaning as provided in section 20-14c; and
(3) “Voluntary nonopioid directive form” means a form that is voluntarily filed by a patient with a prescribing practitioner that indicates such patient's request to not be issued a prescription or medication order for an opioid drug.
(b) The Department of Public Health, in consultation with the Departments of Consumer Protection and Mental Health and Addiction Services, shall establish a voluntary nonopioid directive form and publish such form on its Internet web site for public use. Any person who does not wish to be issued a prescription or medication order for an opioid drug may file such form with a prescribing practitioner. Upon receipt of a voluntary nonopioid directive form, a prescribing practitioner shall document such receipt in the patient's medical record.
(c) The voluntary nonopioid directive form established by the Department of Public Health shall allow a patient to appoint a duly authorized guardian or health care proxy to override a previously recorded voluntary nonopioid directive form. Such patient, duly authorized guardian or health care proxy may revoke the directive, orally or in writing, for any reason, at any time.
(d) An electronically transmitted prescription to a pharmacy shall be presumed to be valid for the purposes of this section and a pharmacist shall not be held in violation of this section for dispensing a controlled substance in contradiction to a voluntary nonopioid directive form.
(e) No prescribing practitioner acting with reasonable care shall be liable for damages in a civil action, subject to criminal prosecution or deemed to have violated the standard of care for such prescribing practitioner for refusing to issue a prescription or medication order for an opioid pursuant to a voluntary nonopioid directive form.
(f) No person acting in good faith as a duly authorized guardian or health care proxy shall be liable for damages in a civil action or subject to criminal prosecution for revoking or overriding a voluntary nonopioid directive form.
(g) A prescribing practitioner who wilfully fails to comply with a patient's voluntary nonopioid directive form may be subject to disciplinary action pursuant to section 19a-17.
(h) No emergency department prescribing practitioner, acting either as the patient's practitioner or as the medical control officer for emergency medical services personnel, and acting with reasonable care shall be liable for damages in a civil action, subject to criminal prosecution or deemed to have violated the standard of care for a prescribing practitioner for issuing a prescription for or administering a controlled substance containing an opioid to a person who has a voluntary nonopioid directive form, when, in such prescribing practitioner's professional medical judgment, a controlled substance containing an opioid is necessary and such prescribing practitioner had no knowledge of the patient's voluntary nonopioid directive form at the time of issuance or administration.
(P.A. 17-131, S. 4; P.A. 25-101, S. 25; 25-168, S. 119.)
History: P.A. 25-101 amended Subsec. (a)(1) by replacing reference to 42 CFR 8.2 with reference to Sec. 20-14o, effective June 24, 2025; P.A. 25-168 made an identical change as P.A. 25-101, effective June 30, 2025.
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Sec. 20-14t. Provision of information re risk of sudden unexpected death in epilepsy. (a) As used in this section:
(1) “Advanced practice registered nurse” means an individual licensed as an advanced practice registered nurse pursuant to chapter 378;
(2) “Physician” means an individual licensed as a physician pursuant to this chapter;
(3) “Physician assistant” means an individual licensed as a physician assistant pursuant to this chapter; and
(4) “Sudden unexpected death in epilepsy” means the death of a person with epilepsy that is not caused by injury, drowning or other known causes unrelated to epilepsy.
(b) On and after October 1, 2025, each physician, advanced practice registered nurse and physician assistant who regularly treats patients with epilepsy shall provide each such patient with information concerning the risk of sudden unexpected death in epilepsy and methods to mitigate such risk.
(P.A. 25-168, S. 178.)
History: P.A. 25-168 effective July 1, 2025.
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