| 20 | | - | Sec. 2. (NEW) (Effective July 1, 2013) (a) The Commissioner of Social Services shall establish a pilot presumptive Medicaid eligibility program for home and community-based care in New Haven County for up to three hundred elderly applicants who require a skilled level of nursing care. Such program shall commence not later than April 1, 2014, and shall include, but not be limited to: (1) The development by the Department of Social Services of a preliminary screening tool to determine whether an applicant is functionally able to live at home or in a community-based setting and is more likely than not to be financially eligible for Medicaid; (2) a written agreement to be signed by such applicant attesting to the accuracy of financial and other information such applicant provides and acknowledging that (A) state-funded services in advance of a final Medicaid eligibility determination shall be provided for not longer than ninety days, and (B) such applicant shall complete a Medicaid application on the date such applicant is screened for functional ability or not later than ten days after such screening; (3) a presumptive financial Medicaid eligibility determination for such applicant by the department not later than four days after such applicant has completed a Medicaid application and is determined to be functionally able to live at home or in a community-based setting; and (4) the initiation of state-funded home and community-based care services for such applicant not later than five days after the applicant has been determined to be presumptively eligible for Medicaid. The Department of Social Services shall make a final determination as to Medicaid eligibility for presumptive eligibility applicants not later than forty-five days after receipt of a completed Medicaid application from such applicant. |
|---|
| 21 | | - | |
|---|
| 22 | | - | (b) Pursuant to state and federal law, the Commissioner of Social Services shall retroactively apply a final determination of Medicaid eligibility for presumptive eligibility applicants for a period not to exceed ninety days. The commissioner shall request available federal matching Medicaid funds for state costs during the presumptive Medicaid eligibility period for applicants determined to be eligible for Medicaid coverage. The commissioner, in consultation with the Commissioner on Aging, shall identify funding pursuant to the federal Older Americans Act of 1965, as amended from time to time, that may be allocated to subsidize costs during the presumptive eligibility period for those applicants who are not determined eligible for Medicaid. State costs during the presumptive eligibility period shall be offset by federal Medicaid reimbursements and savings realized for institutional care that would have been necessary but for the presumptive eligibility system. |
|---|
| 23 | | - | |
|---|
| 24 | | - | (c) Not later than April 1, 2015, the Commissioner of Social Services shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies detailing: (1) The percentage of applicants determined to be presumptively eligible for Medicaid who were not finally determined to be eligible for Medicaid; (2) costs per applicant to provide home and community-based services for the presumptive eligibility period; (3) estimated savings realized by the state on the cost of institutional care for those determined to be eligible for Medicaid; and (4) recommendations on whether the pilot program should be expanded. |
|---|
| 32 | + | Sec. 2. (NEW) (Effective July 1, 2013) Not later than April 1, 2014, the Commissioner of Social Services shall establish a streamlined, uniform process to determine Medicaid eligibility for applicants who are receiving or requesting to receive home and community-based care. Such process shall include, but not be limited to, development of a prescreening tool to be used by the Department of Social Services or its designee to identify in an initial assessment those applicants who are (1) more likely than not to qualify for Medicaid coverage based on their assets and income, and (2) functionally able to receive care in a home or community-based setting. Whenever such applicant for Medicaid has not received an eligibility determination within ninety days of completing such application, the department shall make a presumptive Medicaid eligibility determination and begin providing such-eligible applicant paid home and community-based care. |
|---|