AN ACT CONCERNING OVERSIGHT OF MEDICAL CARE FOR PERSONS WHO ARE INCARCERATED AT THE DEPARTMENT OF CORRECTION.

House of Representatives
sHB5474 / File No. 333 1

General Assembly File No. 333
February Session, 2026 Substitute House Bill No. 5474

House of Representatives, April 1, 2026

The Committee on Government Oversight reported through
REP. DATHAN of the 142nd Dist., Chairperson of the
Committee on the part of the House, that the substitute bill
ought to pass.

AN ACT CONCERNING OVERSIGHT OF MEDICAL CARE FOR
PERSONS WHO ARE INCARCERATED AT THE DEPARTMENT OF
CORRECTION.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Section 18 -81pp of the 2026 supplement to the general 1
statutes is repealed and the following is substituted in lieu thereof 2
(Effective October 1, 2026): 3
(a) As used in this section: 4
(1) "Advanced practice registered nurse" means an advanced practice 5
registered nurse licensed under chapter 373; 6
(2) "Alcohol and drug counselor" means an alcohol and drug 7
counselor licensed or certified under chapter 376b; 8
(3) "Commissioner" means the Commissioner of Correction; 9
(4) "Correctional institution" means a prison or jail under the 10
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jurisdiction of the commissioner; 11
(5) "Dental professional" means a (A) dentist, (B) dental hygienist 12
licensed under chapter 379a, or (C) dental assistant, as defined in section 13
20-112a; 14
(6) "Dentist" means a dentist licensed under chapter 379; 15
(7) "Department" means the Department of Correction; 16
(8) "Discharge planner" means a (A) registered nurse licensed under 17
chapter 378, (B) practical nurse licensed under chapter 378, (C) clinical 18
social worker or master social worker licensed under chapter 383b, or 19
(D) professional counselor licensed under chapter 383c; 20
(9) "HIV test" means a test to determine human immunodeficiency 21
virus infection or antibodies to human immunodeficiency virus; 22
(10) "Medical professional" means (A) a physician, (B) an advanced 23
practice registered nurse, (C) a physician assistant, (D) a registered 24
nurse licensed under chapter 378, or (E) a practical nurse licensed under 25
chapter 378; 26
(11) "Mental health care provider" means (A) a physician who 27
specializes in psychiatry, [or] (B) an advanced practice registered nurse 28
who specializes in mental health , or (C) a physician assistant who 29
specializes in mental health; 30
(12) "Mental health therapist" means (A) a physician who specializes 31
in psychiatry, (B) a psychologist licensed under chapter 383, (C) an 32
advanced practice registered nurse who specializes in mental health, (D) 33
a clinical social worker or master social worker licensed under chapter 34
383b, [or] (E) a professional counselor licensed under chapter 383c , or 35
(F) a physician assistant who specializes in mental health; 36
(13) "Physician" means a physician licensed under chapter 370; 37
(14) "Physician assistant" means a physician assistant licensed under 38
chapter 370; and 39
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(15) "Psychotropic medication" means a medication that is used to 40
treat a mental health disorder that affects behavior, mood, thoughts or 41
perception. 42
(b) Not later than October 1, 2025, the commissioner shall develop a 43
plan for the provision of health care services, including, but not limited 44
to, mental health care, substance use disorder and dental care services, 45
to persons who are incarcerated under the jurisdiction of the 46
department. Such plan shall ensure, at a minimum, that: 47
(1) (A) There is a sufficient number of mental health therapists, as 48
determined by the commissioner, at each correctional institution to 49
provide mental health care services to persons who are incarcerated; 50
(B) There is a mental health therapist placed at a correctional 51
institution to provide mental health care services to any person who is 52
incarcerated who requests such services or has been referred for such 53
services by correctional staff only after the therapist makes an 54
assessment of the person's need for such services and determines that 55
the person requires such services; 56
(C) Each mental health therapist shall deliver such services in concert 57
with the security needs of all persons who are incarcerated and 58
correctional staff and the overall operation of the correctional 59
institution, as determined by the warden of the correctional institution; 60
and 61
(D) No mental health therapist who is providing mental health care 62
services pursuant to this subdivision and licensed to prescribe 63
medication shall prescribe a psychotropic medication to a person who 64
is incarcerated unless (i) the mental health therapist has reviewed the 65
mental health history and medical history of the person, including, but 66
not limited to, the list of all medications the person is taking, (ii) the 67
mental health therapist determines, based on a review of such history, 68
that the benefits of prescribing such medication outweigh the risk of 69
prescribing such medication, (iii) the mental health therapist diagnoses 70
the person with a mental health disorder, the person has received a 71
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previous diagnosis of a mental health disorder by a licensed mental 72
health care provider and such medication is used to treat such mental 73
health disorder, or, in an emergency situation, the mental health 74
therapist makes an assessment that the inmate's mental health is 75
substantially impaired and requires psychotropic medication to treat, 76
(iv) the mental health therapist approves the use of such medication by 77
the person as part of the person's mental health treatment plan, and (v) 78
the mental health therapist keeps a record of each psychotropic 79
medication such provider prescribes to the person and all other 80
medications the person is taking. 81
(2) Each person who is incarcerated shall receive an annual physical 82
examination by a physician, physician assistant or advanced practice 83
registered nurse when such examination is clinically indicated. Such 84
examination may include, but not be limited to, a breast and 85
gynecological examination or prostate examination, where appropriate, 86
and the administration of any test the physician, physician assistant or 87
advanced practice registered nurse deems appropriate. 88
(3) Each person who is incarcerated shall receive an initial health 89
assessment from a medical professional not later than fourteen days 90
after the person's initial intake into a correctional institution. 91
(4) If a physician, physician assistant or advanced practice registered 92
nurse recommends, based on the initial health assessment of a person 93
who is incarcerated or other person, that such person who is 94
incarcerated or other person be placed in a medical or mental health 95
housing unit, the department shall ensure that such person who is 96
incarcerated or other person is placed in an appropriate medical or 97
mental health housing unit unless there are significant safety or security 98
reasons for not making such placement. 99
(5) A medical professional shall perform health assessments of 100
persons who are incarcerated in a location at the correctional institution 101
that the warden of the correctional institution designates as appropriate 102
for performing such an examination, provided the analysis of any 103
sample collected from the person who is incarcerated during a health 104
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assessment may be performed at a laboratory that is located outside of 105
the correctional institution. 106
(6) A discharge planner shall conduct an exit interview of each person 107
who is incarcerated who is being scheduled for discharge from a 108
correctional institution prior to the date of discharge if such exit 109
interview is clinically indicated, provided the lack of such exit interview 110
shall not delay the scheduled discharge of a person who is incarcerated. 111
Such exit interview shall include a discussion with the person regarding 112
a medical discharge plan for any continued medical care or treatment 113
that is recommended by the physician, physician assistant or advanced 114
practice registered nurse for the person when the person reenters the 115
community. 116
(7) A physician shall be on call on weekends, holidays and outside 117
regular work hours to provide medical care to persons who are 118
incarcerated as necessary. 119
(8) The commissioner shall ensure that each person who is 120
incarcerated has access to all vaccines licensed or authorized under an 121
emergency use authorization by the federal Food and Drug 122
Administration that are recommended by the National Centers for 123
Disease Control and Prevention Advisory Committee on Immunization 124
Practices, subject to availability of such vaccines, unless there are 125
substantial security concerns with providing access to such vaccines. 126
Subject to availability, a physician, physician assistant or advanced 127
practice registered nurse shall prescribe to a person who is incarcerated 128
any such vaccine that (A) the person requests, and (B) is recommended 129
for such person by said committee, as determined by the physician, 130
physician assistant or advanced practice registered nurse, provided the 131
prescribing of such vaccine does not impose significant safety concerns. 132
(9) Except in exigent circumstances, a dental professional shall 133
perform a dental screening of each person who is incarcerated not later 134
than one year after the person initially enters a correctional institution 135
and at least once annually thereafter. At the time the dental professional 136
performs the dental screening of a person who is incarcerated, the dental 137
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professional shall develop a dental care plan for the person. A dental 138
professional shall provide dental care in accordance with the person's 139
dental care plan throughout the person's time at the correctional 140
institution. The commissioner shall ensure, in consultation with a 141
dentist, that each correctional institution has a dental examination room 142
that is fully equipped with all of the dental equipment necessary to 143
perform a dental examination. 144
(10) A medical professional shall administer an HIV test to each 145
person who is incarcerated who requests an HIV test, subject to the 146
availability of such test. Except in exigent circumstances and subject to 147
availability, a medical professional shall offer an HIV test to each person 148
who is incarcerated where it is clinically indicated (A) at the time such 149
person enters a correctional institution, or (B) during an annual physical 150
assessment. 151
(11) A medical professional shall interview each person who is 152
incarcerated regarding such person's drug and alcohol use and mental 153
health history at the time the person initially enters a correctional 154
institution. If the person is exhibiting symptoms of withdrawal from a 155
drug or alcohol or mental distress at such time, a medical professional 156
shall perform a physical and mental health assessment of the person and 157
communicate the results of such assessment to a physician, physician 158
assistant or advanced practice registered nurse, and a mental health care 159
provider or mental health therapist, if applicable. Except in exigent 160
circumstances, a drug and alcohol counselor shall perform an 161
evaluation of the person not later than five days after the person initially 162
enters the correctional institution. (A) The correctional institution shall 163
immediately transfer each such person who is determined by a 164
physician, physician assistant or advanced practice registered nurse to 165
be experiencing withdrawal from a drug or alcohol to an appropriate 166
area at such correctional institution for medical treatment of such 167
withdrawal. A physician, a physician assistant or an advanced practice 168
registered nurse shall periodically evaluate each person who is 169
incarcerated and exhibits signs of or discloses an addiction to a drug or 170
alcohol or who experiences withdrawal from a drug or alcohol, at a 171
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frequency deemed appropriate by the physician, physician assistant or 172
advanced practice registered nurse. (B) In the case of a person who is 173
determined at the time of such person's intake into a correctional 174
institution to be in need of mental health services, such person shall be 175
provided evidence -based mental health interventions delivered by a 176
mental health care provider or mental health therapist, as needed, 177
within a reasonable amount of time after such determination of need, 178
but in no case later than two business days following such 179
determination. Such person shall be periodically evaluated by a mental 180
health care provider or mental health therapist and provided such 181
services, as needed. 182
(12) A physician, a physician assistant or an advanced practice 183
registered nurse with experience in substance use disorder diagnosis 184
and treatment shall oversee the medical treatment of a person who is 185
incarcerated experiencing withdrawal from a drug or alcohol at each 186
correctional institution. A medical professional shall be present in the 187
medical unit at each correctional facility at all times during the provision 188
of medical treatment to such person. 189
(13) A drug and alcohol counselor shall offer appropriate substance 190
use disorder counseling services, including, but not limited to, 191
individual counseling sessions and group counseling sessions, to a 192
person who is incarcerated and exhibits signs of or discloses an 193
addiction to a drug or alcohol and encourage such person to participate 194
in at least one counselling session. At the time of discharge of a person 195
who is incarcerated from the correctional institution, a discharge 196
planner may refer any such person who has exhibited signs of or 197
disclosed an addiction to a drug or alcohol while incarcerated at such 198
correctional institution to a substance use disorder treatment program 199
in the community that is deemed appropriate for the person by such 200
discharge planner. 201
(14) The York Correctional Institution shall provide each pregnant 202
woman who is incarcerated and drug or alcohol -dependent, with 203
information regarding the dangers of undergoing withdrawal from the 204
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drug or alcohol without medical treatment, the importance of receiving 205
medical treatment during the second trimester of pregnancy for 206
withdrawal from the drug or alcohol and the effects of neonatal 207
abstinence syndrome on a newborn. 208
(15) The York Correctional Institution shall provide each pregnant 209
woman who is incarcerated prenatal visits at a frequency determined by 210
an obstetrician to be consistent with community standards for prenatal 211
visits. 212
(16) The department shall issue a request for information to which a 213
school of medicine may apply for purposes of providing practical 214
training at correctional institutions as part of a medical residency 215
program, through which residents participating in such program may 216
provide health care services to persons who are incarcerated. 217
(c) Not later than October 1, 2027, the commissioner shall amend the 218
plan developed under subsection (b) of this section to ensure: 219
(1) There is a plan to accredit the program for the provision of health 220
care to persons who are incarcerated, by a national organization 221
approved by the Department of Public Health; 222
(2) An electronic tracking system is created for the administration of 223
medications to persons who are incarcerated according to the schedule 224
established by the medical professional overseeing their care and that 225
will alert the appropriate personnel when such medications have not 226
been timely administered; 227
(3) Persons who are incarcerated may request medical care 228
electronically, if they have access to a portable electronic device, in 229
addition to the existing system of written requests submitted in a drop 230
box; and 231
(4) Any plan of discharge for persons who are incarcerated who are 232
eligible to obtain Medicaid shall include assistance for such persons to 233
apply for coverage prior to discharge from a correctional institution. 234
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[(c)] (d) Not later than [October 1, 2025 ] December 31, 2026, and 235
annually thereafter, the commissioner shall report, in accordance with 236
the provisions of section 11 -4a, to the joint standing committees of the 237
General Assembly having cognizance of matters relating to public 238
health, [and] the judiciary and government oversight regarding any 239
updates on the status of the implementation of the plan developed 240
pursuant to [subsection (b) ] subsections (b) and (c) of this section, 241
recommendations for any legislation necessary to implement such plan 242
and the department's timeline for complete implementation of such 243
plan. For reports submitted after December 31, 2026, the report shall also 244
contain, organized by correctional institution: (1) A summary that 245
outlines the medications prescribed to persons who are incarcerated by 246
major drug classification, the number of doses where the administration 247
was delayed by less than one hour, between one and less than four 248
hours, between four hours and seven hours and thirty minutes, greater 249
than seven hours and thirty minutes or missed entirely, and an 250
explanation for the delayed or missed doses; (2) information regarding 251
the initial health assessment for each person who is incarcerated at the 252
time the person initially enters a correctional institution, and how often 253
such interview is conducted within fourteen days of entry, and the 254
reasons for why such assessment is not conducted within such time 255
period; (3) the number of requests by persons who are incarcerated for 256
medical care, the types of requests and the amount of time that elapsed 257
after the request being made before being seen by a medical 258
professional; and (4) the number of adverse medical outcomes and the 259
length of time the department took to complete an investigation into 260
such adverse medical outcomes. 261
This act shall take effect as follows and shall amend the following
sections:

Section 1 October 1, 2026 18-81pp

GOS Joint Favorable Subst.

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The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of
the General Assembly, solely for purposes of information, summarization and explanation and do not
represent the intent of the General Assembly or either chamber thereof for any purpose. In general,
fiscal impacts are based upon a variety of informational sources, including the analyst’s professional
knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final
products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact:
Agency Affected Fund-Effect FY 27 $ FY 28 $
State Comptroller - Fringe
Benefits1
GF - Cost None 26,672
Correction, Dept. GF - Cost None 563,777
Note: GF=General Fund

Municipal Impact: None
Explanation
The bill adds new requirements in FY 28 to the Department of
Correction’s (DOC) reporting on its plan for providing health care
services, resulting a cost of up to $563,777 to DOC and $26,672 to the
State Comptroller in FY 28.
Beginning in FY 28 the department will be required to report on (1)
medications prescribed by major drug classification (2) status of initial
health assessments (3) the number of requests for medical care and time
elapsed between the request and receipt of care, and (4) adverse medical
outcomes and the length of investigations of such outcomes. These
requirements result in a one -time cost of up to $500,000 to modify the
department’s electronic health record (EHR) system and an ongoing
annual cost starting in FY 28 of $63,777 to DOC and $26,672 to the State
Comptroller – Fringe Benefits to hire a n administrative assistant to
compile this data and ensure accurate reporting and documentation

1 The fringe benefit costs for most state employees are budgeted centrally in accounts
administered by the Comptroller. The estimated active employee fringe benefit cost
associated with most personnel changes is 41.82% of payroll in FY 27.
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year-round.
The bill also requires DOC to make various changes to the
department’s plan for providing health care services, though this
requirement results in no fiscal impact. The department has the
expertise to update the plan in accordance with the bill's provisions and
the bill does not require the department to implement the plan under
any specific timeline.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future, except for the one-time cost to modify the EHR.

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OLR Bill Analysis
sHB 5474

AN ACT CONCERNING OVERSIGHT OF MEDICAL CARE FOR
PERSONS WHO ARE INCARCERATED AT THE DEPARTMENT OF
CORRECTION.

SUMMARY
This bill requires the Department of Correction (DOC) commissioner,
by October 1, 2027, to amend the department’s plan for providing health
care services to incarcerated individuals (see BACKGROUND) .
Specifically, the amended plan must ensure that:
1. there is a plan for DOC’s health care program to get accredited
by a national organization approved by the Department of Public
Health;
2. there is an electronic system to track medication administration
for incarcerated individuals (according to the schedule set by
their providers) and it alerts appropriate personnel when
medications are overdue;
3. incarcerated individuals with access to a portable electronic
device may request medical care electronically, in addition to the
existing system of submitting written requests in a drop box; and
4. for Medicaid -eligible incarcerated individuals, their discharge
plan helps them apply for coverage before being discharged from
the institution.
The bill requires DOC to annually report on implementation of its
health care services plan and related recommendations, and starting
with the report due in 2027 , on additional matters such as (1) lat e or
missed medication administration and (2) adverse medical outcomes.
The bill also adds physician assistants (PAs) who specialize in mental
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health to the list of providers who may serve as “mental health care
providers” or “mental health therapists” under the DOC health care
plan.
EFFECTIVE DATE: October 1, 2026
DOC REPORTING
Starting by December 31, 2026, the bill requires the DOC
commissioner to annually report to the Government Oversight,
Judiciary, and Public Health committees on (1) any updates on the
health care plan’s implementation, (2) the timeline to fully implement it,
and (3) recommendations for any necessary related legislation. Starting
with the report due in 2027, the reports also must include the following,
organized by correctional institution:
1. a summary outlining the medications prescribed to incarcerated
individuals by major drug classification, the number of doses that
were administered late (classified in four specified time bands)
or missed entirely, and an explanation for the delayed or missed
doses;
2. information on the initial health assessment for incarcerated
individuals, how often this occur red within 14 days of the
person’s entry, and when it was not, the reasons why;
3. the number and types of medical care requests by incarcerated
individuals and the time that passed between the request and the
person being seen by a medical professional; and
4. the number of adverse medical outcomes and how long it took
DOC to complete its investigation of these outcomes.
PHYSICIAN ASSISTANTS
Under current law, for purposes of DOC’s health care services plan,
psychiatrists or advanced practice registered nurses ( APRNs)
specializing in mental health can serve as “mental health care
providers,” and psychiatrists or these APRNS, as well as psychologists,
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clinical or master social workers, or professional counselors can serve as
“mental health therapists.” The bill additionally allows PAs specializing
in mental health to serve in either role.
Existing law sets several related requirements under DOC’s plan. For
example:
1. there must be enough mental health therapists at each
correctional institution to provide mental health care services to
incarcerated people;
2. when an incarcerated person requests, or correctional staff refers
the person to, mental health care services, a mental health
therapist must assess whether the services are needed before
providing them;
3. mental health therapists must follow certain procedures when
prescribing psychotropic medications to incarcerated
individuals; and
4. when an incarcerated person, at intake, is determined to need
mental health services, a mental health care provider or therapist,
as needed, must provide the person with evidence -based
interventions within two business days, and a mental health care
provider or therapist must periodically evaluate the person and
provide services as needed.
BACKGROUND
DOC Health Care Services Plan
Existing law requires the DOC commissioner to develop a plan for
providing health care services to incarcerated people at DOC
correctional institutions. The plan must ensure that requirements are
met in a number of areas, such as initial health assessments, annual
physical examinations when clinically indicated, mental health provider
staffing, discharge planning, vaccinations, dental services, drug and
alcohol use treatment, and specific services for incarcerated women who
are pregnant.
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Related Bill
sHB 5567, reported favorably by the Judiciary Committee, (1)
requires DOC to amend its health care services plan to ensure that there
is no interruption in clinically necessary medications upon a person’s
intake, (2) requires DOC to annually report on the plan’s
implementation, and (3) makes several other changes related to health
care for incarcerated individuals.
COMMITTEE ACTION
Government Oversight Committee
Joint Favorable Substitute
Yea 12 Nay 0 (03/17/2026)