THE CONNECTICUT GENERAL ASSEMBLY

THE HOUSE OF REPRESENTATIVES

Thursday, June 1, 2017

(The House of Representatives was called to order at 10: 30 o'clock a. m. , Representative Aresimowicz of the 30th District in the Chair. )

CLERK:

Members to the Chamber. The House of Representatives will convene immediately. Members to the Chamber. (Gavel)

SPEAKER ARESIMOWICZ (30TH):

Will the House please come to order. Will members, staff, and guests please rise and direct your attention to the dais, where Imam Refai Arefin will lead us in prayer.

IMAM REFAI AREFIN:

Thank you, Mr. Speaker. Let us pray. Dear Sustainer of the universe: In this season of growth, let us give thanks for the bounty that we have received during this year. Just as the colors of the mountains and the fruits of the harvest vary in their shades and hues, so do we. We come from many walks of life, yet we have unity of purpose. The people of Connecticut may have different ideas of how to achieve that purpose, but their hopes and aspirations are the same.

We ask from the one God that He grant us inspiration to meet the needs of the future, give us wisdom to make the right decisions, persistence to support them, and radiance that will win others to work with us. Amen.

SPEAKER ARESIMOWICZ (30TH):

Would Representative Currey of the 11th District please come to the dais to lead us in the Pledge of Allegiance.

REP. CURREY (11TH):

(All)I pledge allegiance to the flag of the United States of America and to the republic for which it stands, one nation under God, indivisible, with liberty and justice for all.

SPEAKER ARESIMOWICZ (30TH):

Thanks. Is there any business on the Clerk's desk?

CLERK:

Mr. Speaker, the only business is the daily calendar.

SPEAKER ARESIMOWICZ (30TH):

Are there any announcements or introductions? Representative Vail of the 52nd, you have the floor, Sir.

REP. VAIL (52ND):

Thank you, Mr. Speaker, and I rise for the purposes of an introduction, if I may.

SPEAKER ARESIMOWICZ (30TH):

Please proceed, Sir.

REP. VAIL (52ND):

I'm waiting for Representative Zawistowski to join us. Representative Zawistowski and I, both proud graduates of Stafford High School, not in the same year, a few years apart, are here, and we're proud to introduce a Staff -- a senior at Stafford High, Damon Reynolds. Damon is a member of the Student Council, National Honors Society President, and an attendee of Boys' State, and Damon was also a key cog in my political campaign. He worked diligently to help get me reelected, and he'll be attending UConn this fall, and I'm proud to say he's going to be joining the UConn Republicans, which is a good thing. [Applause] So, thank you. So if we could give him the customary greeting, I'd appreciate it. Thank you. [Applause]

SPEAKER ARESIMOWICZ (30TH):

Thank you very much for coming up today. Representative Zupkus of the 89th, you have the floor, Madam.

REP. ZUPKUS (89TH):

Thank you. I rise for an announcement please.

SPEAKER ARESIMOWICZ (30TH):

Please proceed.

REP. ZUPKUS (89TH):

Thank you. First of all, I'd like to thank you, Mr. Speaker, for starting session on time. It is a wonderful thing. So thank you very much. [Applause]

I would also just to -- like to remind the Chamber and our friends out in the hallways: Tomorrow is dress-down Friday. So it's $ 5 dollars to dress down, $ 10 dollars to dress up. The money goes for the Home of the Brave, which is a women's veteran homeless home for the homeless women and their children. It's a great cause. So make sure you see Representative Abercrombie or myself to pay for tomorrow. Thank you.

SPEAKER ARESIMOWICZ (30TH):

Thank you very much, Madam. Representative McGee of the 5th District, Sir, you have the floor. I see quite the group over to your left.

REP. MCGEE (5TH):

Yeah, you guys can come around. Good morning, Mr. Speaker.

SPEAKER ARESIMOWICZ (30TH):

Good morning.

REP. MCGEE (5TH):

I rise for the purpose of introduction.

SPEAKER ARESIMOWICZ (30TH):

Please proceed, Sir.

REP. MCGEE (5TH):

Thank you so much. Standing behind me along with my colleagues from the Windsor Delegation, Tammy, Scott, and David, we have here -- we have our brightest. Behind me, all from the great town of Windsor, are Windsor Public High School students, and they're here, they're paying all of you a visit, and I want you all, please, join me in welcoming all of the students of Windsor Public High School as they continue out their day today. So join me. [Applause] Thank you, Mr. Speaker.

SPEAKER ARESIMOWICZ (30TH):

Welcome to our Chamber.

DEPUTY SPEAKER MORIN (28TH):

Are there any announcements or introductions? Announcements or introductions? Representative Rose of the 118th District, for what do you rise?

REP. ROSE (118TH):

Good morning, Mr. Speaker, thank you very much, for the purposes of an announcement.

DEPUTY SPEAKER MORIN (28TH):

Please proceed, Madam.

REP. ROSE (118TH):

Good morning, everyone. On behalf of the Milford Delegation, we would like to invite you to come downstairs this afternoon from 11: 00 to 3: 00. We are -- have Milford Day going on. We have clams and oysters and Subway sandwiches and ice cream. So we hope you enjoy and see all the Milford has to offer. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Rose. I'm sure it'll be a good time. Can't top that. As we go on with business, will the Clerk please call Calendar No. 588.

CLERK:

State Of Connecticut House of Representatives Calendar, Thursday, June 1, 2017, on page 38, House Calendar 588, Senate Bill No. 126, AN ACT CONCERNING COMMUNITY HEALTH WORKERS. Favorable report of the Joint Standing Committee on Public Health.

DEPUTY SPEAKER MORIN (28TH):

The fine Chairman of the Public Health Committee, Representative Steinberg.

REP. STEINBERG (136TH):

Good morning, Mr. Speaker. It's a pleasure to see you this morning. Nice to have the sun out. We all feel optimistic today.

DEPUTY SPEAKER MORIN (28TH):

It's a beautiful day, Sir. Please proceed.

REP. STEINBERG (136TH):

I move for acceptance of the bill in concurrence with the Senate.

DEPUTY SPEAKER MORIN (28TH):

The question is acceptance of the Joint Committee's favorable report, passage of the bill in concurrence with the Senate. Representative Steinberg, you have the floor.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. This bill relates to the role of community health workers. As many people are aware, community health workers are playing a more and more important role in the coordination of care in the community setting. We have examples and data indicating they're making a difference, particularly in the area of preventive care in such a ways that we are -- (Gavel)

DEPUTY SPEAKER MORIN (28TH):

Please, can we keep it to a dull roar so the good Chairman can explain and you can actually hear what he's saying? Thank you, Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. As I was saying, we now have both anecdotal and data indicating that they are contributing to the reduction of the cost of health care by helping manage chronic conditions and the bundle of care services in such a way that we are being more efficient in the utilization of those services. Therefore, it seemed appropriate at this time to establish a statutory definition of community health worker and ask the Department of Public Health to investigate the feasibility of a certification program to recognize them and to make sure that we can define the specific trending and requirements for that particular role.

Mr. Speaker, the Clerk is in possession of an amendment, LCO 6222 I believe, if I have that right.

CLERK:

Yes.

REP. STEINBERG (136TH):

Thank you. That's the one I'd like to call that amendment specifically and be given leave of the Chamber to summarize.

DEPUTY SPEAKER MORIN (28TH):

Will the Clerk please call LCO 6222, which will be designated House Amendment "A" -- Senate Amendment "A". I apologize.

CLERK:

Senate Amendment Schedule "A", LCO No. 6222, offered by Representative Steinberg, Representative Srinivasan, et al.

DEPUTY SPEAKER MORIN (28TH):

The Representative seeks leave of the Chamber to summarize the amendment. Is there objection to summarization? If there's no objection, Representative Steinberg, please proceed.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. As I said previously, one of the first objectives of this legislation is to define community health worker. This amendment makes some minor revisions to that definition for clarification purposes to really narrow the focus in an appropriate manner. It also makes some changes as what we require of DPH to do with regard to examining the feasibility of a certification program, and importantly, I believe, removes the fiscal note that was part of the underlying bill. I move adoption.

DEPUTY SPEAKER MORIN (28TH):

The question before the choption -- before the Chamber is adoption of Senate Amendment Schedule "A". Will you remark on the amendment? Representative Srinivasan, you have the floor, Sir.

REP. SRINIVASAN (31ST):

Thank you, Mr. Speaker. Good morning, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Good morning, Sir.

REP. SRINIVASAN (31ST):

Good to see you there bright and early; right?

DEPUTY SPEAKER MORIN (28TH):

Likewise.

REP. SRINIVASAN (31ST):

Thank you. Thank you. So through you, Mr. Speaker, if the good Chairman of Public Health could tell us, what is it that the amendment does in line 13, where "related to social determinants of health"? That is the word that's added there in line 13.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker, and thank the good Representative for the question. Yes, as I mentioned previously, it follows the word "research" and it's intended to give it more specific and clear meaning as to what kind of research will be taken care -- which will be involved, and as the good Representative mentioned, it has to do with the social determinants so that the research is focused on those things that relate most appropriately to the role of the community health worker.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, with this added words in line 13, the research is to social determinants of health. Through you, Mr. Speaker, are we restricting the kind of research that a community health worker will be able to do and provide us valuable information? Because that, as you know, Mr. Speaker, is the whole intent of this community health worker going out to the community, reaching out (a), and bringing back important information. So are we in any way restricting the research?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Mr. Speaker, through you, I suppose you could describe it as restricting. I would prefer that you use the word focusing that research effort in the most appropriate ways. By definition, it does restrict it, but we want to make sure that what they come back to us with is really the kind of information and data that'll be useful in designing a certification program.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Thank you, Mr. Speaker. I, too, like that word. That word is very good. I appreciate that better choice of word, and I will definitely move forward with that.

Through you, Mr. Speaker, when these determinants, now that we're saying they have to be under -- "under the umbrella of social determinants," who decides what they are so that we educate our community health workers as to what is it that they're looking for.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, again, a very good question. We rely to some degree on the Department of Public Health, which has experience not only with monitoring programs in the community, but in being in contact with many experts who are perhaps best informed to make such clarifications and definitions of what those social determinants would be. I also believe it's probably quite likely that experience from other states with some of the kind of programs will help inform our understanding of social determinants. My understanding is there is a lot of research out there already and that that will form the basis of the analysis. Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, then as I see the Department of Public Health along with maybe the other agencies that are involved in health care delivery -- as you can imagine, it's not just public health alone, so many other agencies are involved as well -- in collaboration, all of them together, as I see that, and I want to make sure that's what this language means in this line 13 amendment is that we will then -- not -- we meaning not you and I, but the Agency under the Department of Public Health -- will come with a list as to what are the questions, what are the concerns that they have when a community health worker goes out for a community outreach, and that will be the guideline that the community health worker will be using.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I think the Representative has given a very good summary of exactly the intent of this legislation and the process the DPH will pursue in order to make sure they come up with a really sensible and well-thought-out program. I think that we want to make sure -- and that's why this bill has gone through an amendment -- that we have the definition as clear as possible so that they can pursue their tasks successfully.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, when we are focusing on the social determinants that we are now coming up with guidelines which the social worker -- the community social worker will go out to the community at large, do we have such examples of things happening in other parts of the nation as well?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, and another good question. Not only do I understand that there are good models in other parts of the country, which we've drawn on, my recollection is we have some successful programs even here in the state of Connecticut which may form the basis for some of their initial deliberations in framing of the certification program. So we even have some in-state experience.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, do we address anywhere in the amendment that when this is the ask of our community social worker and they do not comply with that in one form or the other, (a) they do not get enough information, and swinging the pendulum the opposite way, they go beyond what the ask is. Is that -- which is definitely a concern -- is that addressed anywhere in line 13 or in the amendment?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Mr. Speaker, through you, to answer the good Representative's question, that is not implicit or explicit in that particular line of the definition, nor is it truly addressed in the bill more broadly.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I mean, it is a good amendment. I mean, I am on the amendment, so I definitely feel it's a good amendment, no question about that at all. But one of the restrictions I feel or the limitations, and maybe as we always do in the Chamber, take our first step, maybe take two steps, and then we can always revisit that, which is obviously a very reasonable and a fair approach -- because my concern is that with these community workers, when they go out, I have seen -- you know, being in practice myself, I mean, though they are not statutorily, but they are people who get information, a lot of information, unnecessary information, and I'm obviously concerned about, you know, what is it that these people are going to ask (a), which the good Chairman said we do have a model for that, and obviously we're coming up with outlines. But moving forward, if they are not complied with, either not getting the information or getting too much information, maybe that might be a conversation for another day, but that's something we need to keep in mind as we move forward because good as it is, it is important that we also address the other issue.

Moving, Mr. Speaker, in the amendment, now we move to line 14, and in line 14, again, after the word "assessment of any risks associated with social determinants of health," so we come back to our baseline of social determinants, and so what is it that we're looking for in terms of risks associated with social determinants of health?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, this additional change to the definition in the amendment is similar to the former -- the previous changes the good Representative brought up. It is to make much more specific and focused the specific assessments they want to look at; precisely to the point that the good Representative brought up, to make sure that we get the quality information rather than irrelevant information or too much information. This is to keep us focused on social determinants.

I am not an expert in this field, so I cannot tell you precisely what the risks are necessarily, but we know that because we have broadly different socioeconomic conditions in the state of Connecticut with tremendous gaps in access to care that the circumstances related to social determinants may vary from one community to the next, from one setting to the next.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I get that, that, you know, all of us cannot be experts on every field here, and that's why we are what we call a citizen legislator, but through you, Mr. Speaker, my concern is we need to know what the risks are because that's what we're going to be outlining -- that's what we're going to requesting our social workers, our community workers to go out to.

Through you, Mr. Speaker, the risks of social determinants, what would they be, through you, Mr. Speaker, for a community health worker to address when he or she goes out into the community at large?

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I share the good Representative's sensitivity and concern about making sure we know what those risks are. Indeed, this is the purpose of the bill, to have the experts involved and the Agency involved explore them thoroughly so we can really understand the dimension and the variety of risks that are inherent.

I can speculate up to a certain point, as I said. In some of our communities, there are risks related to low socioeconomic situations; there are certainly some circumstances where certain diseases, particularly chronic diseases, are more prevalent. I could just throw out as an example perhaps diabetes or asthma related to obesity whereby understanding those risks and those social determinants will have an impact in the definition of a certification program for a community health worker.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Thank you. Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, that definitely makes a lot of sense, and I'm glad you explained that to all of us in the Chamber here because the community health worker's going to go out, is going to assess multiple things, and yes, we have some kind of a guidelines, but also for us to be aware of where the ask is and where the excessive, you know, kind of outreach that the community health service person could do is a concern for all of us, and I'm glad you were able to address that for all of us here in the Chamber.

Those -- the first two requests or concerns on the amendment are relatively the milder part or the easier part of the amendment. Through you, Mr. Speaker, my bigger concerns are in striking lines 15 to 23. Through you, Mr. Speaker, I did hear the good Chairs talk about the fiscal note being eliminated because of that strike, and through you, Mr. Speaker, what is it that was struck off in 15 to 23, and what is it that we're replacing with in the lines in the amendment?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, and again, that's an excellent question. This is really the gist of the amendment: It is effectively a strike-all of the previous def -- explanation of what the certification program will be and the roles and responsibilities of the Department of Public Health with regard to pursuing the feasibility of that certification program. I guess the operative phrase is that in the underlying bill it addressed within available resources, and in this case, in an understanding with DPH, this gives them the appropriate clarification of their role such that they should be able to manage within their existing resources. I believe it's also somewhat more explicit in terms of the specific areas in which they need to evaluate before coming back to the Legislature with recommendations for a certification program.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I perhaps viewed this from line 7 on in the amendment a little differently, and I just want to make sure the good Chair and I, who are by and large always on the same page, you know, in our -- in our discussions, you know, in the sessions so far, and I'm sure we will be as we move forward as well. But I just want to make sure that both myself and the Chamber is clear as to who is going to take the lead in terms of coming with recommendations back to the Legislature with regards to a certification program.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, if I understand the question, the good Representative is asking for a little more clarification on roles and responsibilities as per the amendment. And he makes a good point. The legislation as amended calls for an advisory committee administered by DPH to do this background work explicitly to get into the requirements for certification and renewal of certification of these kind of community health workers, including training, experience, or continuing education, and also the methods of administering such a program so we do it right coming right out of the gate, including the application, the standardized assessment of experience, knowledge, and skills, and to create an electronic registry so we can really keep track of these workers in a way which I think is very proactive and appropriate.

And lastly, also requirements for recognizing trending program curricula so that when we stipulate specific training for these workers, we know exactly how they're going to be trained and that we can be assured that when they're certified, they are totally qualified to perform the role for which we've defined.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, as I see in line 7 to perhaps to line 12, so it is the Director of the State Innovation Model. It is the director of that particular program who, as I read it and I see that, is responsible primarily in conjunction with the Advisory Committee and the Department of Public Health; is that my understanding?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. I -- through you, I stand corrected. It's under the administration of the committee, but the good Representative is correct; that individual is charged with the specific responsibility of pursuing this analysis.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, this Director of the State Innovation Model Program -- through you, Mr. Speaker, where does he or she come in as far as being related or connected to the committee -- the working committee and DPH? Is that an independent initiative program?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, my understanding is this particular individual is most expert in analyzing and designing these kinds of programs, and is, therefore, being brought in as an expert in that aspect as opposed to being an expert necessarily in public health, and that's why he's working under the auspices -- her or she, I guess -- under the auspices of the DPH Committee so that we have the benefit of the expertise of someone who has designed such programs in a variety of contexts, and that it can be customized for the specific goal we have for community health workers.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Mr. Speaker, I definitely applaud the intent of this amendment because as I see here we have a State Innovation Model, somebody who is knowledgeable on innovation, somebody who is able to think outside the box and not just continue status quo. So we definitely need somebody who has the capacity -- he or she have the capacity to come up with a new model, because that's what we're doing here. We are stepping out from the areas that we're familiar with in public health and reaching out to the community through another pair of arms, and in doing so, this State Innovation Model, the person there running that particular program, to me, he or she would definitely be the right person to be given that charge to coordinate and make sure that things are done appropriately.

But, through you, Mr. Speaker, this State Innovation Model, innovation program, that person is he or she currently a part of DPH, or are we going to go outside of DPH to be able to get an individual with this background?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I do not know.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, so we are looking at somebody who's going to be, as I envision it, coordinating the three arms: (a) you have the innovation program, you have the Community Health Advisory Committee, and then we have DPH. So through you, Mr. Speaker, this person that we are looking at, how is he or she connected to the other two arms that obviously are critical in moving this forward when we are trying to get a certification program?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Through you, Mr. Speaker, excellent question. My understanding of the bill is that DPH has ultimately responsibility for fulfilling the intent of the legislation. The individual we've been discussing has been brought in as, I suppose, an expert in this particular area.

And I want to reiterate a state the good Representative has made, which is this does involve a measure of innovation. Our experiments, if you will, in the community setting have yielded a lot of interesting new best practices. So we want to take advantage of our understanding of efficiency and quality in the community setting and make sure that is enshrined in our training and our expectations of community health workers so that they are active participants and contributors to really what is often a team approach to addressing needs in the community. So I think it's really appropriate that somebody with some background in innovation and modeling is the person that we're bringing in to add that special expertise so that we really get it right when we create this certification program.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I definitely get that, that this person that we are getting, he or she is a relative expert in innovation, and that is why we're bringing him or her in to help us, to guide us in making the right steps and getting the certification program. I get that.

But my question, through you, Mr. Speaker, is such a person already on the staff of DPH, whose salary and benefits and all of that put together is already accounted for, or is it somebody that we're getting from outside who is not part of DPH, and hence, we would be -- we would be responsible -- we meaning DPH and DPH meaning us -- directly, indirectly for this person's (a) salary, (b) all the benefits?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I can't say with certainty, but by the explicit wording in this proposed legislation referring to that person as "the director of," I think it's fairly safe to presume this is somebody in the employ of the State of Connecticut who has been actively involved in such projects across state agencies, and therefore, yes, would be, in some form or another, a regular employee as contrasted with a consultant.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, what I then understand is within the state agencies within our state, already in employment in some other agencies, involved with other work, maybe all of it could be innovation and in coming up with better and brighter ways of doing business in our state. So as I envision that, so that person, him or her, would then be tapped to say one more responsibility within your timeframe, so on and so forth, being reasonable for anybody's working capacity. Not everybody spends as much time as we do here in the Legislature, especially in the last two weeks. So that such person is going to be guiding DPH, and this person is not a member of DPH on DPH's -- in terms of their staff already.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, that sounds good to me.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, before we go to the Advisory Committee and the role of DPH, line 8 talks about "within available resources. " Through you, Mr. Speaker, what are we referring to, and whose resources are we looking at?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, indeed, a very good question. I'm sure the good Representative is as familiar as I am with the constraints of our agencies and various people we bring into the equation to meet the needs that are posed in legislation. In this case, it is particularly important because initially we weren't sure we were going to have the available resources. My understanding is the amendment creates the kind of focus so that it is highly likely that within the existing resources they will be able to fulfill the obligations we put forward in the legislation.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, as I understand it, and I heard the good Chairman when he brought the amendment out saying that there is no fiscal component; there is no fiscal impact at all if this legislation or when this legislation moves forward. So through you, Mr. Speaker, am I to understand, and I want to make sure the Chamber is also aware, that there is no fiscal note attached to this amendment or to the underlying bill?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, that is my understanding in having researched it. I certainly hope I'm correct.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, so if it is within available resources, which I definitely get it, I definitely understand, and who better than all of us here in the Chamber are well aware of the fiscal responsibility that we all have and the state of the State that we are in at this point. So given all of that, given where we are in 2017, and we just had the mitigation bill discussed last -- yesterday evening, so try to cover this particular year in 2017 -- through you, Mr. Speaker, since it is within available resources, who then prioritizes as to is this work going to be done? Or is this legislation a feel-good legislation where we say this should be done, but guess what, we don't have the money so we are not moving forward?

Through you, Mr. Speaker, where is the relative priority?

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, another good question. Fortunately, while we may entrust the Department of Public Health with the ultimate responsibility of oversight and fulfilling the obligations of the legislation and setting priorities, as the good Representative knows, we have a very good relationship with the Department and its commissioner, and we fully expect that considering how much this matters to all the Chairs and the Ranking Member, that there'll be ongoing communication to assure that they're making progress in this regard, and that if there are any issues, we will be made aware of them in a timely basis. I am confident, however, that they will be able to fulfill their obligations as stated in the legislation frankly because they signed onto it.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I definitely get that, that it is within available resources and so the Department will then decide whether it is a relatively priority. The reason I bring that up and I'm sure the good Chair is aware that when we had the public hearing on this, the -- I did not see the Commissioner or the Commissioner's testimony. I'm not sure whether he came in person to do that or he just submitted the testimony; memory fails me at this point. And the Department is not opposed to defining; that is the way I read it, whereas I would've pref -- I would've thought if they felt that it was important, important enough to do that, they would've used stronger language in a more proactive way as opposed to being "not opposed to. "

Through you, Mr. Speaker, since what we heard was "not opposed to," will this be a priority for the Commissioner within available resources?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, indeed, a good question. I think we all share the concerns we have these days with our agencies, which are undergoing some budget constraints, whether or not they'll be able to fulfill not only the requirements of new legislation, even many of their tasks under existing statute. So it's a very apt question, and we have to be very serious. I do recall that initially the Agency was not as emphatically enthusiastic. We would not be talking about this bill today without the amendment, which makes such clarifications. That gives me confidence that they will be in a position to fulfill it and that it will be a priority for the Department.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Thank you, Mr. Speaker. So through you, Mr. Speaker, if the Department has acquiesced to move this forward, but my concern then is that if that is not their top priority, and given the fact there is no extra funding -- on that we're all very clear -- we're very -- the Chamber will all agree on one thing; we're not going to be putting in more money in any of these programs because we don't have the money to do so. That's simple as that. So through you, Mr. Speaker, will then the Department be able to look at this, get this person that is from another agency or within the Department itself, have such a person who is going to be the Chief of Innovation, whatever name you want to give that title that you want to give that particular person, to be able to work with that? Do we have any guarantees from the Department that this will be something that they will be able to move forward knowing very well that they were not fully gung-ho in support of this work just because they don't have the resources?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, I agree with the good Representative. I wish I could provide such guarantees that DPH will be able to seamlessly and expeditiously execute the entire program. I can only go based upon what promises or at least representations they made to us that they will be able to manage this within their portfolio of priorities and that we will be in consistent communication to see how they're doing, and it's always possible we may need to revisit this at a future date, but again, the amendment reflects the understanding we have with the Department such that they're confident and we're confident we will be able to manage this within existing resources.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, as I see it here, we have this State Innovation Model program "expert supervisor," whatever title you want to give him or her, working with DPH and also with the Advisory Committee. So through you, Mr. Speaker, this Health Worker Advisory Committee, is that a standing committee, or where is this committee in terms of its functionality as we speak?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, an excellent question. I'm not exactly sure, but in reading the specific language of the bill, it does describe "established by the Commissioner of Public Health. " So I interpret that as meaning that they are creating such a committee explicitly for this role, but there may be those involved who have had experience in similar types of committees in the past.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, the Chair and I are on the same page because I read it the same way, too, that this bill -- this committee as we speak is not there, but it will be something that'll be created if this legislation were to move forward. And do we have the details as to what will this committee look like, and what are the rules and regulations behind the formation, and obviously, if this committee will continue, or will it dissolve, and if so, when?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, again, a good question. Obviously, the bill as amended does not explicitly explain some of those details. My understanding is DPH has lots of experience in the creation and management of such committees, both using internal resources and appropriate experts, and that it should be relatively straightforward to both establish and manage such a committee for this explicit and narrow purpose.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, as I understand it, then we are charging DPH -- we're giving DPH the responsibility of "creating" such an Advisory Committee.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Again, thank you for the question because, to be perfectly clear, we should also acknowledge that this Office of Innovation Modeling Management will play a role in the creation of this so that the two components of expertise, the innovation modeling and the public health components, will work collaboratively to assure that we have the right people on this committee for the purposes that are set out in the bill.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, we here in the Chamber are very familiar with creating task force with working with forming various kinds of working groups. So through you, Mr. Speaker, we as a Legislature are not involved in this process of creating this Advisory Committee.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, my understanding is this will be their responsibility, and given their previous experience, it's reasonable for us to entrust them with this responsibility.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

So through you, Mr. Speaker, the State Innovative Program, the coordinator or the person leading that program in conjunction with DPH will create this working committee, advisory committee. And then who then decides what are the criteria that are needed for the certification?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, again a good question, which really speaks to some of the changes we found in the amendment, as the good Representative brought up, the clarifications, the focusing of the definition, and the clarification and focusing of the feasibility study for the certification program. It's very important that they're focused on the most important criteria. Again, I'm no expert. I could not enumerate all those things that will be important for them to look at within the community setting within the context of innovative modeling programs, but by having these two parties work together, I'm confident that they will have a good feel for the criteria or will be capable of soliciting that kind of expert input they need to assure the criteria they've established is indeed the most effective.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, my concern is we're very familiar with the adage "too many cooks" and then you know what happens. So through you, Mr. Speaker, I want to make sure that we are all clear as to who is going to be coming up with the criteria for the certification. Is it going to be the Advisory Committee, is it going to be DPH, or is it going to be the Innovation Model? I get that. They all will be speaking to each other. We all do, but somebody has to have the final charge, the final responsibility like we have here. You know, we all talk about multiple bills, but it's finally the responsibility of the Chair or Public Health (a) to put it together, a public health bill, and bring it out. So he is charged with that responsibility, so similarly here. Through you, Mr. Speaker, since three different groups of people are involved, and I do believe the Advisory Committee will play a significant role, but will it be their recommendations that will come to us at the appropriate time?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, based upon the good Representative's analogy, there are many areas in which I am not expert, but certainly I would add to that the culinary arts. I am not an expert about cooking, as my wife can attest, and I do understand that in most kitchens they do have more than one cook if they're going to get the job done. But to the good Representative's point, there is usually a head cook, somebody in charge, the chef.

REP. SRINIVASAN (31ST):

Right.

REP. STEINBERG (136TH):

And my understanding, as the bill is written, is that we are entrusting this Director of the Innovation Modeling --

REP. SRINIVASAN (31ST):

Okay.

REP. STEINBERG (136TH): -- to take the lead, but obviously, he would not bring forward recommendations that were not in accord with those from the Department of Public Health.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I do want to thank the good Chair for his comments on his culinary skills and bringing out the importance of a head chef, which is extremely important, and that exactly was what I was alluding to. So all of here in the Chamber, before we cast our vote yea or nay on the amendment, know who is going to be the head person, who is going to be the head honcho here as far as the certification process is concerned.

And I just want to make sure that, finally, yes, we are the Working Committee; yes, we have DPH; but it is this Innovation Model, the person in charge of that, whoever the person is, wherever we bring him or her from, is going to be responsible for the various criteria that have been set forth in lines 14 through 21.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, to reiterate, my understanding is it will be this Director of Innovation Management, if that is the question that the good Representative is asking, will be the chef in this soufflé. But as I said, I really expect this to be a collaborative effort, and I do not expect necessarily there to be broad disagreement on either the criteria or the specifics of the program process to really be at issue. I do believe that it'll be a very informed conversation based upon research and data, and that they will probably be in fairly easy concurrence on exactly what they want to do to go forward.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I definitely agree with my Chair once again, that we hope that the conversation is going to be productive, is not going to be counterproductive. I hope, and we all hope, that this conversation will get us to where we want to go to, which is coming up with the criterion for the certification process. But for all of us to be clear that when there are discussions and when there is -- and there could be -- we all know that -- difference of opinion, not on the end goal but how to get to the end goal, there can always be differences, the paths chosen could very be different, the criteria could be different -- so for us all to be clear at the end of the day, the person who is going to be finally getting all of this together, putting all of this discussions with the working committee, with DPH, is going to be the State Innovation Model person, who then will bring this information to us.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, again, a good clarification on the part of the good Representative. Perhaps I'm naïve, not having experienced any disagreement here in this Chamber, so perhaps I have not anticipated the possibility of disagreement within the context of this effort, but I do believe that they will be able to come to an amiable solution, which will incorporate the good thinking of all the parties involved. And obviously, when we talk about such a group, it'll also bring in experts from different disciplines, particularly from the community, so that there may be any number of conversations in which there is not perfect agreement or consensus, but that they will abide by appropriate process in coming to agreement, and that we'll all be satisfied with that result.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Srinivasan.

REP. SRINIVASAN (31ST):

Through you, Mr. Speaker, I want to thank the good Chair for giving us this opportunity to flush out some of the concerns that we had on this amendment. This is definitely a right direction for us to go. We do need the community health worker; no question about that at all. Their value when they go out into communities is phenomenal. People talk to them. People will engage in them, things that they will tell a community health worker, which they will not tell necessarily a health care provider for whatever be the reason.

And, Mr. Speaker, as you know, myself being physician here in private practice, I've experienced this all the time. I'm always amazed when patients would come to me, we would talk, have a good conversation, all medical related, 10 or 15 minutes, that, this, and the other. And the lady would've not informed me that she is pregnant because: (a) she did not think it was relevant to the conversation, or (b) felt uncomfortable telling something personal that she felt was not directly connected to what she was here in the office to take care of. And then the same person, the same lady, would go to my nurse, who is the next step in the office to get her allergy evaluation -- and guess what? -- the first thing she would say is by the way, you know what? I'm pregnant.

And so it is important for all of us in the

Chamber for me to share that experience because when a patient goes to a healthcare provider, whether it be a male or a female, an M. D. or an A. P. R. N. , there is that level, unfortunately, of intimidation, and certain information, valuable information is not necessarily shared. But when you have somebody else who is a team work, who works as -- in the team, and they are able to get that information and bring that back to you, it is a win/win situation for everyone: (a) the healthcare provider because the right decisions are made knowing what is happening, and more importantly, for the person, for the patient who seeks that help and the role of this community worker is phenomenal. It's something we need to be heading in the right direction, and I'm sure there'll be a lot of other questions from colleagues, both sides of the aisle, discussing this very important step, a bold step for us in our state, but a necessary step for us so that we achieve our goals.

Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Srinivasan. Will you remark further on Senate Amendment "A"? Representative Candelora of the 86th District, good morning, Sir.

REP. CANDELORA (86TH):

Good morning, Mr. Speaker. Thank you. Mr. Speaker, if I might, a couple of questions to the proponent of the amendment.

DEPUTY SPEAKER MORIN (28TH):

Please proceed, Sir.

REP. CANDELORA (86TH):

Thank you, Mr. Speaker. Specifically, I see that this amendment, we're directing the Director of the State Innovation Model Innovative Program Management Office to sort of set up a study versus the underlying bill, which I think was broader, had more of a collaboration with Department of Public Health, DSS, and DMHAS as well. I'm just wondering why the bill is tailored down, why this amendment has narrowed it down to this working group.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Sir. Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, a good question. I believe it reflects the realities of the availability of resources across agencies. We've been promised that they will be involved, that there will be contributions of their specific expertise in this group, but it is, one could argue, somewhat more streamlined in order to achieve the specific objective of creating a definition and a program for community health workers such that we have really tried to explicitly define which resources are absolutely essential to this process. But I can assure the good Representative the intention and the assurances we received from the agencies is that we will have all the requisite input we require to make sure we're making a good decision.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Candelora.

REP. CANDELORA (86TH):

Thank you, Mr. Speaker, and Mr. Speaker, this -- the Community Health Worker Advisory Committee, which will now be charged to look into this, as I'm reading it, it's -- in the amendment it states that this committee's established by the Commissioner of Public Health, and I want to confirm -- I believe that this is already an existing committee, but I'm not sure on that. And would the Representative know if this is, in fact, an existing committee, and was it maybe a creature of statute?

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Through you, Mr. Speaker, I do not have that specific information, but I agree with the good Representative in his interpretation that such a committee has existed at some time and has performed similar roles, so that it will be relatively straightforward to make sure that they are commissioned to this task.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Candelora.

REP. CANDELORA (86TH):

Thank you, and I also, I guess, through you, in line 7, we have a reference to this Director, and I think there was discussion over the resources and the existence. It's my understanding, just looking at the Public Health's website, that this Director already does exist.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes, thank you for -- I agree with the good Representative's interpretation, and I hope that is the case.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Candelora.

REP. CANDELORA (86TH):

Thank you, Mr. Speaker. Mr. Speaker, I guess I don't have any further questions right now, and I understand what we're trying to accomplish, I think, through this piece of legislation, and, you know, I may have further questions when the amendment is adopted. But it's my understanding that the Community Health Worker Advisory Committee does already exist. I think they're already performing this task as I just have done a little bit of research. And it also looks as if that one of the things that this Committee is being charged with as well is finding options for sustainable financing of these particular community workers, and I guess I do have one final question on that.

Is the intent of this -- I guess, broadly speaking I try to wrap my arms around. We're trying to shift to a lot of home health care, you know, provisions, where we're providing the health services in people's homes, and so I know we have, you know, nurses that go out and provide medication, and, you know, those individuals are reimbursed through our Medicaid and through our health insurance system. This certification process, you know, seems to be in its infancy, and I'm just wondering globally how this fits into the Health Care Model. Are these individuals -- you know, they sort of have a dual role, I think, of maybe acting as, you know, almost in a loose term of like a social worker trying to maybe train people to understand how to use the health care system, encouraging them if -- you know, if they have a certain type of illness that they would go to a pediatrician versus an emergency room. You know, is that the underlying intent of what this workforce is being charged with looking at? And do we know if we've contemplated how these services, if created, would be paid for?

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I think that that's an excellent question and comment and really speaks to the heart of why we are trying to establish in statute the need to define and create a certification program for this particular kind of worker, because it is new. We have experience, and they are playing an important role where we are beginning to establish best practices and see some greater efficiencies and, more importantly, greater -- better health outcomes with regard to this. But it is relatively new, and we are dealing with some vagaries of both the health system as it exists today and is going through changes and also the insurance system and the compensation for this kind of work.

I view these community health workers as partners with other health professionals in assuring that we have a program for each individual, which acknowledges their particular health needs. It helps them find the services, as the good Representative put forward, to make sure they're in appropriate management. This is often about continuity of care, consistency of care for those particularly who have conditions that can become expensive over time, and the community setting has been shown to be an appropriate place for us to intercept individuals who are displaying potentially expensive health conditions and help them manage their health in a -- on a timely basis and in an efficient way to reduce the strains on our healthcare system.

So to answer the good Representative's question, he's really right on the mark. There are issues with regard to the compensation for these workers because they're relatively new in the scheme of things. And that's why it is explicitly stipulated in the amended part of the bill that we examine that and we understand it and look to other states to make sure that if there are appropriate models out there to assure that these workers will not only be well trained and certified, but that they will be able to perform well and continue to be compensated appropriately in the healthcare marketplace. That's really important to making sure this program works. So I thank the good Representative for help -- giving me a chance to clarify just how important this is and how important it is for a new idea to get it right.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Candelora.

REP. CANDELORA (86TH):

Thank you, Mr. Speaker, and I do appreciate those answers. It does, I think, help frame why the amendment is the way it is, and I don't have any further questions. Thank you.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Sir. Will you remark further? Representative Ackert of the 8th District.

REP. ACKERT (8TH):

Good morning, Sir.

DEPUTY SPEAKER MORIN (28TH):

Good morning, Sir.

REP. ACKERT (8TH):

Through you, a couple questions to the proponent of the amendment.

DEPUTY SPEAKER MORIN (28TH):

Please proceed.

REP. ACKERT (8TH):

You know, when you have some -- a lot of dialogue going on, you have a lot of time to do research, and not having served on the Public Health Committee for a little bit of time, I kinda went through and looked up some of the acronyms that we have here with the Community Health Network Advisory Committee and SIM, the State Innovation Model Initiative Program. So SIM has active in researching already this community health worker process, and they have a full report. They've been working on it since last fall, actually, and they have a full report that they've released on the training.

So let's start with their recommendation. Their recommendation was, I think, the reverse of what we're doing with the amendment. SIM, State Innovation Model, said that DPH should do what we're now asking SIM to do on their report. So SIM came up with, okay, you need to come up with a certification program, bring -- you know, develop, you know, the -- you know, the model that would be certification, and now, for some reason, that section -- essentially, that section will be changed, 7 through 27 on the amendment, tosses it back to SIM to do this work. Is that, through you, Mr. Speaker, the understanding of this amendment?

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I want to thank the good Representative for giving me an opportunity to laud the accomplishments of the SIM Initiative, which we depend on very heavily for a variety of health-related innovations. They're an important component of our overall ability to make progress on public health in a changing marketplace.

I do not interpret the language exactly the same as the good Representative. I think it really commissions a collaborative effort where we take advantage of the insights, experience, and research that SIM and other experts have -- can bring to the party, but still holds DPH responsible, as is typically the case when it comes to certification programs, for making sure that they -- that when we create such program, their ability to execute it appropriately, just like we ask them for all other certification programs. So I view this as a truly collaborative effort rather than one or the other.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Ackert.

REP. ACKERT (8TH):

And I accept that. That's an excellent view of that. Now, since this is a new position essentially, and maybe it's a newer position overall nationally, it looks like what we're trying to do is we have an understanding that we're going to have -- and the report as to the good Chair's excellent report, the work they accomplished in a short amount of time for the understanding of this, it shows the value of SIM and what they can do for the health field here in Connecticut. Is there existing training programs out there, and I'm not saying in the Connecticut base, but out there that would meet the needs that we're trying to research, if the good Chair has a knowledge of that, that others have a certification program with the training that this amendment is focused on?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, that's an excellent question. I am not specifically aware of certification programs in other states, but I'm confident that there are good training models out there, which we will examine to consider incorporating into our Connecticut-specific certification program for training so we can take advantage of the curricula that may be out there which relate directly to this. My guess is since this is still a relatively new worker definition, there may be more than one training model out there, and we'll need to give due consideration to what levels and types of training are most appropriate to assure the safety and efficacy in the Connecticut community environment.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Ackert.

REP. ACKERT (8TH):

Thank you, Mr. Speaker. Thank you to the good Chair for his answers. Right now, there's obviously individuals practicing, maybe not with this title, but out there practicing. As the good doctor had mentioned, he relies heavily on support, the dialogue that takes place between a patient, someone that's going to provide health -- and their provider. At this time, what -- is there a social worker or someone in the communities that may fit right into this and be essentially, as I read through the SIM report, grandfathered in to provide these services and get this certification?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, yes. It's an excellent question. My surmise would be that somebody with a social work background would have a lot of the requisite skills and experience to be effective in this role, but I also imagine there may be a variety of types of individuals with related expertise who have served in some aspect of a community health worker. Indeed, the purpose of this legislation is to assure that whoever serves in this role has a consistent and well-defined training and expertise regimen so that we don't have any doubts as to whether or not they have the requisite expertise.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Ackert.

REP. ACKERT (8TH):

Thank you, Mr. Speaker, and thank you to the good Chairman. And that's something that's quite important. When we start to look at -- and I think the collaboration is going to be key. You know, DPH is going to have a role. You know, I almost think that, you know, we're -- granted, we're worried about money. We are worried about money, but sometimes when you look at a good policy, a small investment with DPH, they're going to have to something on this. We know that. And so we get it. The amendment strikes the money part, and it puts it into SIM to do the work, which it looks like, from what I've read on some of the reports, they can handle it. Through you, is it probably an understanding that the training would be provided by multiple facets, but probably, since it's a certification program, something that our Board of Regents and the community colleges would be probably signed on to do this work?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, again, a very good question. I think that brings us back to the original conversation about the amendment and how it adds to the definition focused on social determinants, and I think that described the -- sort of the point of difference about the role that a community health worker would play in the community, that they have to be particularly sensitive and aware to the variety of factors that are affecting the health profile of those in their care, and that they are able to develop a tailored solution in conjunction with other health experts so we can effectively and efficiently manage the care of that individual to protect their health and to limit expenses related to it. So I think that that is perhaps one of the more important distinctions, is that we have to consider their care within the context of their social environment and their particular situation.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Ackert.

REP. ACKERT (8TH):

Thank you, Mr. Speaker, and I think part of certification sometimes mean that maybe it's going to be covered through insurance policies, and once you get certified, insurances recognize that probably as a viable component to the health. Is it the good understanding of the gentleman that as we go through here that this would be part of that healthcare role that insurance policies would be covering to assist in the communication between patient and doctor? Is that where we think we're moving with this legislation?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I do not see this individual replacing or interjecting themselves in the relationship between physician and patient. Their role is, I think, more collaborative in that sense. They will add value by having information available that perhaps the practitioner is not aware of. But to the good Representative's underlying question, yes, I think it's a fair assumption that once certification occurs, that there will be some effort to seek compensation through the insurance industry. Obviously, what's going on in insurance these days and healthcare includes many unknowns, but we do know from experience that insurance companies are always interested in opportunities to reduce the cost of care, particularly in the preventative area, and that potentially these community health workers will facilitate that outcome and should interest insurers to cover their services to save them money.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Ackert.

REP. ACKERT (8TH):

Thank you, Mr. Speaker, and I want to thank the good Chair for his answers and dialogue up to this time. This has been very enlightening. Obviously, not serving on Public Health this year, it gives me a chance to get back into it a little bit and do some research as to what we're doing for good work out there through the SIM program, State Innovation Model, and through our Community Health Work Advisory Committee. So sometimes when you establish this, you actually get solid results, and as I look through the reports, there are solid results coming from here. I'll hold off now any further questions on the amendment and may come up with questions regarding the underlying legislation once this amendment moves forward, if it moves forward. Thank you, Mr. Speaker, and thank you to the good Chairman for his answers.

DEPUTY SPEAKER MORIN (28TH):

And thank you for your questions. From the 112th District, Representative Sredzinski.

REP. SREDZINSKI (112TH):

Thank you, Mr. Speaker. I want to thank the good Chairman for his answering of the questions, and I actually have a few, and I hope I don't repeat any of the questions. I had to step out of the Chamber for a moment on a legislative matter. But if I can, through you, Mr. Speaker, a couple of question to the proponent of the amendment.

DEPUTY SPEAKER MORIN (28TH):

Please proceed, Sir.

REP. SREDZINSKI (112TH):

Thank you, Mr. Speaker. I know that a large part of the amendment removes the $ 26,000 dollar fiscal note, and in reading that, it looks as if that fiscal note, that $ 26,000 dollars was in there for DPH to provide the study of this community health worker in fiscal year '17. It was removed as part of the Governor's holdbacks, and then it was moved forward as an annualization of those holdbacks for next year. So my question, through you, Mr. Speaker, is the importance of this has obviously been debated and discussed, but is this something that needs to get done next year, or is it a possibility that we could wait?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, an excellent question by the good Representative. I think the fact that this legislation is important to us this year reflects the fact that we have more and more experience. There are more people entering this field, and they're having a positive impact on healthcare costs and safety. So it is in our interests to make this a priority, as Representative Srinivasan brought up. The fact that DPH is willing to make this a priority within their broad portfolio responsibilities is an indication that there is a real opportunity for us to take advantage of it at this time. So I would argue that this is a worthy piece of legislation to accomplish this year. I share the good Representative's concerns about budget constraints. This is affecting us across the board, but I'm heartened by the aspect of this bill which would lead to reduction of healthcare costs, which we know would also benefit the state. So I would argue it is in our interests to see such legislation move forward.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Sredzinski.

REP. SREDZINSKI (112TH):

Thank you, Mr. Speaker. And since the original bill had a $ 26,000 dollar fiscal note in order to complete the study, and now we are, I'm assuming, looking at the bill and the amendment, going to still do the study, but it's not going to cost $ 26,000 dollars, my question, through you, are we still getting the same end result as we would have originally?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Through you, Mr. Speaker, excellent question. I certainly hope so. The changes that are underlying the amendment relate to the participation particularly of other agencies, which did have a fiscal impact. We have been assured that they will participate and contribute as needed, but perhaps we have done a better job with the amendment of defining exactly the roles for all the players involved so that we do not waste resources, and therefore, can live within existing resources.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Sredzinski.

REP. SREDZINSKI (112TH):

Thank you, Mr. Speaker. And I also hope the same, and I thank the good Chairman for his answers. And again, I believe I did hear some of this discussed. I didn't hear a clear answer, and I'm not sure if we have this, but are there other states -- through you, Mr. Speaker, are there other states in the United States that define a community health worker, what they do, what their role is, and how they provide care to our community?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Steinberg.

REP. STEINBERG (136TH):

Thank you, Mr. Speaker. Through you, I'm not precisely sure as to the status of specific certification programs in other states, but I do know that other states are examining this area as we are because we all are having experience with community health workers and the role that they're playing. So I think it's reasonably expected if such certification programs do not already exist in other states that they will soon.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Ritter. Chamber will stand at ease.

The esteemed Majority Leader, Representative Ritter.

REP. RITTER (1ST):

Mr. Speaker, top of the morning to you -- afternoon now. I move that we pass this item temporarily. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Without objection, the bill passes temporarily.

Chamber will stand at ease.

Are there any announcements or introductions? Announcements or introductions? Well, Representative Hoydick of the 120th District, for what reason do you rise, Madam?

REP. HOYDICK (120TH):

Thank you, Mr. Speaker. For -- I rise for a -- the privilege of an introduction.

DEPUTY SPEAKER MORIN (28TH):

Well, please proceed.

REP. HOYDICK (120TH):

Thank you, Mr. Speaker. God works in strange ways. I thank the Majority Leader for postponing the debate so I have the opportunity to introduce the members of the class from Nichols School. They are from Stratford. They are in the gallery. Representative McGorty, Representative Gresko, and I will be up in the gallery in a minute to greet you personally, but if the Chamber would give them a warm welcome, I would be most appreciative. [Applause]

DEPUTY SPEAKER MORIN (28TH):

Well, we welcome them, and I hope they have a great visit here to the State Capitol. Are there any further announcements or introductions? Will the Clerk please call Calendar No. 443.

CLERK:

On page 24, Calendar 443, Senate Bill 867, AN ACT CONCERNING NOTICE REQUIREMENTS FOR HOME HEALTH CARE REGISTRIES. Favorable report of the Joint Standing Committee on General Law.

DEPUTY SPEAKER MORIN (28TH):

Well, Representative Baram.

REP. BARAM (15TH):

Morning -- good morning, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Good morning.

REP. BARAM (15TH):

Mr. Speaker, I move for acceptance of the Joint Committee's favorable report and passage of the bill in concurrence with the Senate.

DEPUTY SPEAKER MORIN (28TH):

The question before the Chamber is on acceptance of the Joint Committee's favorable report and passage of the bill in concurrence with the Senate. Representative Baram, you have the floor, Sir.

REP. BARAM (15TH):

Thank you, Mr. Speaker. Mr. Speaker, this is a simple, but important bill. It requires that the statutory notice be given to a consumer prior to the commencement of services by a home healthcare registry. What this notice does is provide the consumer with information that explains that because they become the employer of the person placed in the home to care for the individual consumer, that they may become responsible for taxes, social security, overtime, unemployment, workers' comp, etc. A home healthcare registry differs from a companion agency in that the agency remains the employer of the employee, where a home care registry just places the employee in the home, and the consumer oftentimes becomes responsible as an employer. So by giving prior notice to the consumer, that way the consumer will have a full understanding of their legal obligations. The only exception is that if there is a bona fide emergency, the bill give a four-day grace period before notice has to be given.

Mr. Speaker, I would move passage of the bill.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Baram. Will you remark further? Representative Smith of the 108th District, you have the floor, Sir.

REP. SMITH (108TH):

Thank you, Mr. Speaker, and good afternoon, Sir.

DEPUTY SPEAKER MORIN (28TH):

Good afternoon to you.

REP. SMITH (108TH):

Thank you. Once again, the Chairman has given an excellent rendition of what the bill stands for. You know, as a lawyer, I was surprised when this bill came before our Committee because having notice after the fact of what your obligations are kinda surprised me, but that's how the current legislation stands and the current statute stands, so that a consumer could be -- could have entered into a contract without actually knowing what the contract says. This bill, in my mind, makes perfect sense. It's required to be given to the consumer at the time of the contract, even before, and not after unless there is an emergency. So my only question, through you, Mr. Speaker, to the good Chairman is the bona fide emergency exception that's set forth in this proposed bill, if you could give a few examples of how that would apply.

Through you.

DEPUTY SPEAKER MORIN (28TH):

Representative Baram.

REP. BARAM (15TH):

Through you, Mr. Speaker, examples of an emergency might include a holiday -- national religious holiday on the weekend or at the time that the services are about to commence. It could be a family emergency where perhaps the guardian or the conservator has to be out of town or gets ill. The grace period just gives a few extra days, but the emergency has to be documented on a separate form, signed by all parties, including the consumer or the person responsible for their legal care, so that it is not fabricated or not made up, but it has to be legitimate, and those would be a few examples.

DEPUTY SPEAKER MORIN (28TH):

Representative Smith.

REP. SMITH (108TH):

I thank the Chairman for the response, and I think it's also important that he pointed out that there just can't be a fabrication of an emergency. There actually has to be a bona fide emergency, and the form has to be filled out and filed. I'm not sure who it gets filed with, but maybe the Chairman knows, if he could tell me if he knows the answer to that question.

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Baram.

REP. BARAM (15TH):

Through you, Mr. Speaker, to my knowledge, the form is not filed with any State agency; it is just there in the records so that if a question arises later on, both the consumer and the registry have a copy of that form and it can be produced.

DEPUTY SPEAKER MORIN (28TH):

Representative Smith.

REP. SMITH (108TH):

And lastly, Mr. Speaker, the requirement that there still be some type of notice to the consumer of the contents of the contract is still required, as I read the amendment -- or actually the legislation, rather, and it has to be done within four days; am I correct in my interpretation?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Baram.

REP. BARAM (15TH):

Through you, Mr. Speaker, that's correct.

DEPUTY SPEAKER MORIN (28TH):

Representative Smith.

REP. SMITH (108TH):

Mr. Speaker, I encourage my colleagues to support this bill. It's a common-sense bill. It's a consumer protection bill, and I urge everybody to support it. Thank you.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Smith. Will you remark further? Representative Dubitsky of the 47th District, you have the floor, Sir.

REP. DUBITSKY (47TH):

Thank you, Mr. Speaker. Just one quick question for the proponent, if I may.

DEPUTY SPEAKER MORIN (28TH):

Of course, please proceed.

REP. DUBITSKY (47TH):

Thank you. The current law requires this notice -- actually, I'm asking if current law currently requires this notice and this bill is simply a -- provides for an exception for certain circumstances, including bona fide emergencies; do I interpret that correctly?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Baram.

REP. BARAM (15TH):

Through you, Mr. Speaker, fairly accurate. The current law requires notice within four days after the commencement. So the first thing we're doing is we're making the notice requirement prior to commencement, and then because of that, we added the four-day emergency provision, which does not exist right now because you have a four-day grace period. But we understand that the DCP has received a number of complaints and concerns expressed by people who undertake a person who's placed by a registry in their home, and then lo and behold, they find out that they become the employer, and they're responsible for taxes and unemployment insurance. And so we want to make sure that everybody has a full legal explanation and understanding before they commit to the services.

DEPUTY SPEAKER MORIN (28TH):

Representative Dubitsky.

REP. DUBITSKY (47TH):

Thank you, Mr. Speaker, and the good Representative answered my question thoroughly. Thank you.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Sir. Will you remark further? Representative Wilson of the 66th District, you have the floor, Sir.

REP. WILSON (66TH):

Thank you. Thank you, Mr. Speaker. Just want to clarify in my mind. As I read this, it would seem that the underlying purpose is to clarify and make sure that it's fully disclosed before engagement that we may or may not be in an independent contractor status. Through you, Mr. Speaker, to the proponent, is that correct?

DEPUTY SPEAKER MORIN (28TH):

Representative Baram.

REP. BARAM (15TH):

Through you, Mr. Speaker, that's correct.

REP. WILSON (66TH):

And I thank you for that answer --

DEPUTY SPEAKER MORIN (28TH):

Representative Wilson.

REP. WILSON (66TH):

-- and just a comment here. I do sit on the Board of a VNA and Nurses' Registry Service, and I know that this has been an issue, and so I do support this bill. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Wilson. Will you remark further? Will you remark further on the bill? If not, will staff and guests please come to the well of the House. Will members please take your seats. The machine will be open. [Ringing]

CLERK:

The House of Representatives is voting by roll. Members to the Chamber. The House of Representatives is voting by roll. Members to the Chamber.

DEPUTY SPEAKER MORIN (28TH):

Have all the members voted? Have all the members voted? Will members please check the board to determine if your vote is properly cast. If all members have voted, the machine will be locked, and the Clerk will take a tally. Will the Clerk please announce the tally.

CLERK:

Senate Bill 867 in concurrence with the Senate:

Total Number Voting 149

Necessary for Passage 75

Those Voting Yea 149

Those Voting Nay 0

Absent and Not Voting 2

DEPUTY SPEAKER MORIN (28TH):

The bill passes. (Gavel)

Are there any announcements or introductions? Announcements or introductions? Representative Staneski of the 119th, for which reason do you rise, Madam?

REP. STANESKI (119TH):

Thank you, Mr. Speaker. I rise for a point of introduction, please.

DEPUTY SPEAKER MORIN (28TH):

Well, please proceed.

REP. STANESKI (119TH):

Thank you, Sir. Well, we all know it's Milford Day, as the good Representative Rose announced earlier. So I encourage all of my colleagues in the House and friends here to go down and partake in the wonderful food we have down there. But I have on the floor with me a couple of people that I wanted to make a special -- take a special opportunity to introduce.

My friend here, Gloria Lanna; this is her very first time and she has been in Connecticut for all of the 20 years that she is of age in Connecticut, and she is -- this is her first time to the House. She is a volunteer and board member for United Way, an organization in Milford that is very special to me.

And to my right here is Ray Vitale. He is also on the board of United Way. He is the Chairman of the Milford Prevention Council. You've heard me speak many times on this floor that that's an organization that I helped start in Milford. He also is a retired administrator. So while I sit on higher ed. , I'm always getting information from him about what we need to do to fix our education system. I keep telling him he needs to be up here if he wants to make that change.

And my very good friend here, Wendy Gibbons, who works for Bridges with mental health, but also is our Executive Director of Milford Prevention Council.

They are here for Milford Day down in the North Lobby, but I wanted us to give them a warm welcome, and I wanted to take the opportunity to show them this beautiful room. So thank you very much, Mr. Speaker. [Applause]

DEPUTY SPEAKER MORIN (28TH):

Thank you very much, Representative Staneski, and we warmly welcome you here. We hope you enjoy your day. I'm very envious. I have not had the opportunity to go downstairs because you won't talk long enough, so I have not been able to partake, but we're glad to welcome Milford to the House today. Thank you for coming.

Will the clerk please call Calendar No. 159.

CLERK:

On page 6, Calendar 159, Substitute House Bill No. 7141, AN ACT CONCERNING SECURED AND UNSECURED LENDING. Favorable report of the Joint Standing Committee on Banking.

DEPUTY SPEAKER MORIN (28TH):

Well, the fine Chairman of the Banking Committee, Representative Lesser.

REP. LESSER (100TH):

Good afternoon, Mr. Speaker. Mr. Speaker, I move acceptance of the Joint Committee's favorable report and passage of the bill.

DEPUTY SPEAKER MORIN (28TH):

The question is acceptance of the Joint Committee's favorable report and passage of the bill. Representative Lesser, you have the floor, Sir.

REP. LESSER (100TH):

Yes, thank you, Mr. Speaker. Mr. Speaker, the Clerk is in possession of an amendment, LCO 8212. I ask that the Clerk please call the amendment and that I be granted leave of the Chamber to summarize.

DEPUTY SPEAKER MORIN (28TH):

Will the Clerk please call LCO 8212, which will be designated House Amendment Schedule "A".

CLERK:

House Amendment Schedule "A", LCO No. 8212, offered by Representative Lesser, Senator Winfield, Representative Simanski.

DEPUTY SPEAKER MORIN (28TH):

The Representative seeks leave of the Chamber to summarize the amendment. Is there objection to summarization? Is there objection? Hearing none, Representative Lesser, you may proceed with summarization.

REP. LESSER (100TH):

Thank you, Mr. Speaker. Mr. Speaker, this is a strike-all amendment that, if adopted, would become the bill. I'll briefly gloss over some of the changes since Committee. One of them is to give the Commissioner additional powers to submit notices via email as opposed to certified mail. I believe that has been negotiated in consultation with licensees. It also makes some changes to the -- to various provisions related to mortgage banking and to lead generators. Mr. Speaker, I move adoption.

DEPUTY SPEAKER MORIN (28TH):

Will you remark further? Remark further on the amendment before us? Representative Simanski of the 62nd District, good afternoon, Sir.

REP. SIMANSKI (62ND):

Good afternoon, Mr. Speaker. I stand in strong support of this bill as amended, and this amendment, in fact, is a strike-all, so it becomes the bill. As the good Chairman said, this tightens the laws. It gives the Commissioner ability to go after deceptive and fraudulent acts within the various licensees in the financial community listed in this amendment. It also brings the banking industry into the 21st Century -- the Banking Department, rather, because it allows for licensing renewal online, and it does allow for electronic notification via email, which is good. It streamlines the process, so it's good for the Banking Department as well as the various licensees in the financial industry.

This iteration -- this amendment that we have here before us is now the result of many hours of negotiation between the Department of Banking and the financial services industry, and one of the big, big, major changes to this bill that we have here in front of us is Section 28 pertaining to mortgage servicers. And I would like to ask the Chairman, through you, Mr. Speaker, why was this section put into the bill -- into this amendment?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Lesser.

REP. LESSER (100TH):

Thank you, Mr. Speaker. Through you, to the Honorable Ranking Member, first of all, I appreciate the gentleman's kind remarks. You know, my understanding is that there were a few bad acts by mortgage bankers in the state, and the Commissioner was looking to expand powers to go after licensed entities that had failed to supervise their staff. Now, in consultation with industry and the Department, we believe that this expanded authority is important, but there are kinks that still need to be worked out. And so my hope is that the language in the -- in Section 28 as amended allows those discussions to continue in a way that is both -- allows for strong enforcement powers, but also works for industry.

So through you, Mr. Speaker, I hope that answers the question.

DEPUTY SPEAKER MORIN (28TH):

Representative Simanski.

REP. SIMANSKI (62ND):

Thank you, Mr. Speaker. And it did answer my question. I think it's important for the Chamber to know that even though this section was put into the amendment, it was not in the original bill. It's not really new language because it was originally in the Lead Generators Bill that we passed in concurrence with the Senate last week. This language came out of that bill and is more appropriate put into this bill here because this bill addresses licensing for all financial services, and it more properly belongs in this bill.

The hours of negotiation between the financial services and the Banking Department were a result primarily of this Section 28 because the intent is to get to the evil person who does the dastardly deed, commits the fraud within the mortgage servicing industry, and we didn't think that this language really got to that specific person. The language here is more of a shotgun approach. It aims at the people in the entire community, whereas the Connecticut Bankers Association would like the language more restricted. After hours and hours of negotiation, we decided that this language is appropriate, but we still want to see the negotiations continue between the Banking Department and the Connecticut Bankers Association to refine the language and to make it more pertinent to identifying that one specific individual who we want to address.

So through you, Mr. Speaker, to the Chairman of the Banking Committee, what are we doing to ensure that the negotiations continue between the Department of Banking and the Connecticut Banking Association?

Through you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Representative Lesser.

REP. LESSER (100TH):

Thank you, Mr. Speaker. Through you, to the Honorable Ranking Member, I think the answer is in Section 28. We pushed out the effective date of that section to encourage discussions to go forward.

DEPUTY SPEAKER MORIN (28TH):

Representative Simanski.

REP. SIMANSKI (62ND):

Thank you, Mr. Speaker. And I agree with the Chairman, and I thank him for coming up with the idea to extend the time for this to become in effect for a year so the negotiations can continue, we can come up with language that is absolutely right for the banking industry, and I would urge all my members to support this bill as amended. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Simanski. Will you remark further? Will you remark further on the amendment before us? If not, I will try your minds. All those in favor, please signify by saying aye.

REPRESENTATIVES:

Aye.

DEPUTY SPEAKER MORIN (28TH):

All those opposed, nay. The ayes have it. The

(Gavel) amendment is adopted. Will you remark further on the bill as amended? Will you remark further on the bill as amended? Yes, Representative Lesser.

REP. LESSER (100TH):

Thank -- thank you, Mr. Speaker. Mr. Speaker, the bill as amended, it does what my Honorable Ranking Member said earlier, and it provides consistent enforcement powers across multiple license types as well as provide increased consistency for prohibited practices across the same. It's a good bill, ought to pass, and thank the Chamber for adopting the amendment.

DEPUTY SPEAKER MORIN (28TH):

Will you remark further? Will you remark further? If not, will staff and guests please come to the well of the House. Members, please take your seats. The machine will be open. (Ringing)

CLERK:

The House of Representatives is voting by roll. Members to the Chamber. The House of Representatives is voting by roll. Members to the Chamber.

DEPUTY SPEAKER MORIN (28TH):

Have all the members voted? Have all the members voted? Will members please check the board to determine if your vote is properly cast. If all members have voted, the machine will be locked and the Clerk will take a tally. Will the Clerk please announce the tally.

CLERK:

House Bill 7141 as amended by House "A":

Total Number Voting 149

Necessary for Passage 75

Those Voting Yea 146

Those Voting Nay 3

Absent and Not Voting 2

DEPUTY SPEAKER MORIN (28TH):

The bill as amended passes. Gavel)

Will the Clerk please call Calendar No. 596.

CLERK:

On page 40, Calendar 596, Substitute Senate Bill No. 809, AN ACT ENABLING THE INSURANCE COMMISSIONER TO ADOPT REGULATIONS CONCERNING CREDITS FOR REINSURANCE AND MAKING MINOR CONFORMING CHANGES TO STATUTES CONSIDERING REINSURANCE. Favorable report of the Joint Standing Committee on Insurance and Real Estate.

DEPUTY SPEAKER MORIN (28TH):

Representative Scanlon.

REP. SCANLON (98TH):

Good afternoon, Mr. Speaker. I move for the acceptance of the Joint Committee's favorable report and passage of the bill in concurrence with the Senate.

DEPUTY SPEAKER MORIN (28TH):

The question is acceptance of the Joint Committee's favorable report and passage of the bill in concurrence. Representative Scanlon, you have the floor, Sir.

REP. SCANLON (98TH):

Thank you, Mr. Speaker. This bill -- I have an amendment here, and I'm going to ask my good friend, the Ranking Member, to just proceed as usual we do with the amendment, and then we can talk about the subject of the bill. The amendment is technical in nature. This bill did pass the Senate, and with that said, Mr. Speaker, I ask the Clerk, who has an amendment before him, LCO 6120, I would ask the Clerk to please call the amendment and that I be granted leave of the Chamber to summarize.

DEPUTY SPEAKER MORIN (28TH):

Will the Clerk please call LCO 6120, which will be designated Senate Amendment "A".

CLERK:

Senate Amendment "A", LCO No. 6120, offered by Senator Looney, Senator Duff, et al.

DEPUTY SPEAKER MORIN (28TH):

The Representative seeks leave of the Chamber to summarize the amendment. Is there objection to summarization? Is there objection? Hearing none, Representative Scanlon, you may proceed with summarization.

REP. SCANLON (98TH):

Through you, Mr. Speaker, again, this bill is very -- the amendment, rather, is very technical in nature. It did pass the Senate, and I move adoption.

DEPUTY SPEAKER MORIN (28TH):

The question before the Chamber is adoption of House Amendment -- or rather Senate Amendment Schedule "A". Will you remark further on the amendment? Representative Sampson of the 80th District, you have the floor, Sir.

REP. SAMPSON (80TH):

Good afternoon, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Good afternoon.

REP. SAMPSON (80TH):

I concur with my good friend, the esteemed Chairman of the Insurance Committee, that this is a technical amendment only, and I encourage my colleagues to vote in favor. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Representative Sampson. Will you remark further? Will you remark further on the amendment before us? If not, I will try your minds. All those in favor, please signify by saying aye.

REPRESENTATIVES:

Aye.

DEPUTY SPEAKER MORIN (28TH):

All those opposed, nay. The ayes have it. The amendment is adopted. (Gavel)

Will you remark further on the bill as amended? No? Will you remark further on the bill as amended? If not, will staff and guests please come -- oh, I didn't see a name. I apologize. Representative Sampson, please proceed, Sir.

REP. SAMPSON (80TH):

Thank you very much, Mr. Speaker. And forgive me, I had expected the Chairman to make some comments about the bill, but I will just say that this is a very, very positive step forward again for the insurance industry in our state. This essentially is kind of a technical bill, but it creates a situation that -- or rather fixes something in our current law that would prohibit certain types of reinsurance companies for getting credit on their bottom line essentially for reinsurance from non-admitted carriers where they receive that benefit in some places, but in other parts of our law they do not. This puts us in line with other states. It is beneficial to the industry, and I urge adoption. I think it's a great bill. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

Thank you, Sir. I apologize for the quick call. Will you remark further? Will you remark further on the bill as amended? If not, will staff and guests please come to the well of the House. Will the members please take your seats, and the machine will be open. (Ringing)

CLERK:

The House of Representatives is voting by roll. Members to Chamber. The House of Representatives is voting by roll. Members to Chamber.

DEPUTY SPEAKER MORIN (28TH):

Have all the members voted? Have all the members voted? If all members have voted, the machine will be locked, and the Clerk will take a tally. Will the Clerk please announce the tally.

CLERK:

Senate Bill 809 as amended by Senate "A" in concurrence with the Senate:

Total Number Voting 149

Necessary for Adoption 75

Those Voting Yea 146

Those Voting Nay 3

Absent and Not Voting 2

DEPUTY SPEAKER MORIN (28TH):

The bill as amended in concurrence with Senate passes. (Gavel)

Are there any announcements or introductions? Announcements or introductions? Representative Candelora.

REP. CANDELORA (86TH):

Thank you, Mr. Speaker. Mr. Speaker, the House Republicans will be caucusing upon recess in Room 110.

DEPUTY SPEAKER MORIN (28TH):

Recess is good. Representative Albis.

REP. ALBIS (99TH):

Thank you, Mr. Speaker. The House Democrats will be caucusing upon recess in Room 207A, and with that, I move that we recess subject to the Call of the Chair.

DEPUTY SPEAKER MORIN (28TH):

Is there objection? Seeing no objection, the House will stand in recess subject to the Call of the Chair.

(On motion of Representative Albis of the 99th District, the House recessed at 12: 46 o'clock p. m. , to reconvene at the Call of the Chair. )

(The House of Representatives reconvened at 3: 35 o'clock p. m. , Deputy Speaker Morin of the 28th District in the Chair. )

DEPUTY SPEAKER MORIN (28TH):

Representative Ritter.

REP. RITTER (1ST):

Thank you, Sir. I'm going to move that we adjourn subject to the Call of the Chair. Thank you, Mr. Speaker.

DEPUTY SPEAKER MORIN (28TH):

The motion is to adjourn subject to Call of the Chair. Is there objection? Hearing none, the House is adjourned subject to the Call of the Chair.

(Gavel)

(On motion of Representative Ritter of the 1st District, the House adjourned at 3: 36 o'clock p. m. , subject to the Call of the Chair. )

CERTIFICATE

I hereby certify that the foregoing 116 pages is a complete and accurate transcription of a digital sound recording of the House Proceedings on Thursday, June 1, 2017.

I further certify that the digital sound recording was transcribed by the word processing department employees of Alphatranscription, under my direction.

________________________

Alpha Transcription

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