Connecticut 2015 Regular Session

Connecticut House Bill HB06895 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	General Assembly Substitute Bill No. 6895
2		-	January Session, 2015 _____HB06895AGE___030915____
	1	+	General Assembly Raised Bill No. 6895
	2	+	January Session, 2015 LCO No. 3911
	3	+	03911_______AGE
	4	+	Referred to Committee on AGING
	5	+	Introduced by:
	6	+	(AGE)
3	7
4	8		General Assembly
5	9
6		-	~~Substitute~~ Bill No. 6895
	10	+	Raised Bill No. 6895
7	11
8	12		January Session, 2015
9	13
10		-	_____HB06895AGE___030915____
	14	+	LCO No. 3911
	15	+
	16	+	03911_______AGE
	17	+
	18	+	Referred to Committee on AGING
	19	+
	20	+	Introduced by:
	21	+
	22	+	(AGE)
11	23
12	24		AN ACT REQUIRING THE STATE OMBUDSMAN TO INVESTIGATE COMPLAINTS CONCERNING RECIPIENTS OF HOME AND COMMUNITY-BASED CARE.
13	25
14	26		Be it enacted by the Senate and House of Representatives in General Assembly convened:
15	27
16	28		Section 1. Section 17a-405 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
17	29
18	30		(a) As used in this chapter:
19	31
20	32		(1) "State agency" means the Department on Aging.
21	33
22	34		(2) "Office" means the Office of the Long-Term Care Ombudsman established in this section.
23	35
24	36		(3) "State Ombudsman" means the State Ombudsman established in this section.
25	37
26	38		(4) "Assistant State Ombudsman" means the person appointed by the State Ombudsman to assist the State Ombudsman in carrying out the duties of the State Ombudsman pursuant to section 17a-408, as amended by this act.
27	39
28	40		[(4)] (5) "Program" means the long-term care ombudsman program administered by the Office of the Long-Term Care Ombudsman established in this section.
29	41
30	42		[(5)] (6) "Representative" includes the Assistant State Ombudsman, a regional ombudsman, a residents' advocate or an employee of the Office of the Long-Term Care Ombudsman who is individually designated by the State Ombudsman.
31	43
32	44		[(6)] (7) "Resident" means an [older] individual who resides in or is a patient in a long-term care facility who is sixty years of age or older.
33	45
34	46		[(7)] (8) "Long-term care facility" means any skilled nursing facility, as defined in Section 1819(a) of the Social Security Act [,] (42 USC 1395i-3(a)); any nursing facility, as defined in Section 1919(a) of the Social Security Act [,] (42 USC 1396r(a)); a board and care facility as defined in Section 102(19) of the federal Older Americans Act [,] (42 USC 3002(19)); and for purposes of ombudsman program coverage, an institution regulated by the state pursuant to Section 1616(e) of the Social Security Act [,] (42 USC 1382e(e)) and any other adult care home similar to a facility or nursing facility or board and care home.
35	47
36	48		[(8)] (9) "Commissioner" means the Commissioner on Aging.
37	49
38	50		[(9)] (10) "Applicant" means an [older] individual who has applied for admission to a long-term care facility or for home and community-based services.
39	51
40	52		(11) "Home and community-based services" means long-term care provided in a home or community setting, or both, to a recipient who is sixty years of age or older.
41	53
42	54		(b) There is established an independent Office of the Long-Term Care Ombudsman within the Department on Aging. The Commissioner on Aging shall appoint a State Ombudsman who shall be selected from among individuals with expertise and experience in the fields of long-term care and advocacy to head the office and the State Ombudsman shall appoint [assistant] an Assistant State Ombudsman and regional ombudsmen. In the event the State Ombudsman [or an assistant regional ombudsman] is unable to fulfill the duties of the office, the commissioner shall appoint an acting State Ombudsman. [and] In the event the Assistant State Ombudsman or a regional ombudsman is unable to fulfill the duties of the office, the State Ombudsman shall appoint an acting [assistant] Assistant State Ombudsman or an acting regional ombudsman, as the case may be.
43	55
44	56		(c) Notwithstanding the provisions of subsection (b) of this section, on and after July 1, 1990, the positions of State Ombudsman, Assistant State Ombudsman and regional ombudsmen shall be classified service positions. The State Ombudsman and regional ombudsmen holding said positions on said date shall continue to serve in their positions as if selected through classified service procedures. As vacancies occur in such positions thereafter, such vacancies shall be filled in accordance with classified service procedures.
45	57
46	58		Sec. 2. Subsection (a) of section 17a-406 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
47	59
48	60		(a) Residents' advocates shall be appointed by the State Ombudsman, in consultation with the regional ombudsmen, for each region in sufficient number to serve the long-term care facilities and recipients of home and community-based services within such region. Such residents' advocates shall, if possible, be residents of the region in which they will serve, and shall have demonstrated an interest in the care of the elderly. Residents' advocates shall serve without compensation but may be reimbursed for reasonable expenses incurred in the performance of their duties, within available appropriations.
49	61
50	62		Sec. 3. Section 17a-408 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
51	63
52	64		(a) The State Ombudsman shall establish and operate ombudsman programs in this state pursuant to Sections 711 to 713, inclusive, of the federal Older Americans Act of 1965, as amended from time to time.
53	65
54	66		(b) The State Ombudsman shall serve on a full-time basis, and shall personally or through representatives of the office:
55	67
56	68		(1) Identify, investigate and resolve complaints that:
57	69
58	70		(A) Are made by, or on behalf of, residents of long-term care facilities and recipients of home and community-based services or, as to complaints involving the application for admission to a long-term care facility or for home and community-based services, by or on behalf of applicants; and
59	71
60	72		(B) Relate to action, inaction or decisions that may adversely affect the health, safety, welfare or rights of the residents of long-term care facilities and recipients of home and community-based services, including the welfare and rights of the residents and recipients with respect to the appointment and activities of guardians and representative payees, of (i) providers or representatives of providers of long-term care services, (ii) public agencies, or (iii) health and social service agencies;
61	73
62	74		(2) Provide services to protect the health, safety, welfare and rights of the residents of long-term care facilities and recipients of home and community-based services;
63	75
64	76		(3) Inform the residents of long-term care facilities and recipients of home and community-based services about means of obtaining services provided by providers or agencies described in subparagraph (B) of subdivision (1) of this subsection or services described in subdivision (2) of this subsection;
65	77
66	78		(4) Ensure that the residents of long-term care facilities and recipients of home and community-based services and, as to issues involving applications for admission to long-term care facilities or for home and community-based services, applicants have regular and timely access to the services provided through the office and that the residents, recipients and complainants receive timely responses from representatives of the office to complaints;
67	79
68	80		(5) Represent the interests of the residents of long-term care facilities and recipients of home and community-based services, and of applicants in relation to issues concerning applications to long-term care facilities and for home and community-based services, before governmental agencies and seek administrative, legal and other remedies to protect the health, safety, welfare and rights of the residents of long-term care facilities and recipients of home and community-based services;
69	81
70	82		(6) Provide administrative and technical assistance to representatives and training in areas including, but not limited to, Alzheimer's disease and dementia symptoms and care;
71	83
72	84		(7) (A) Analyze, comment on and monitor the development and implementation of federal, state and local laws, regulations, and other governmental policies and actions that pertain to the health, safety, welfare and rights of the residents of long-term care facilities and recipients of home and community-based services with respect to the adequacy of long-term care facilities and home and community-based services in this state and to the rights of applicants in relation to applications to long-term care facilities or for home and community-based services;
73	85
74	86		(B) Recommend any changes in such laws, regulations, policies and actions as the office determines to be appropriate; and
75	87
76	88		(C) Facilitate public comment on such laws, regulations, policies and actions;
77	89
78	90		(8) Advocate for:
79	91
80	92		(A) Any changes in federal, state and local laws, regulations and other governmental policies and actions that pertain to the health, safety, welfare and rights of residents of long-term care facilities and recipients of home and community-based services with respect to the adequacy of long-term care facilities and services in this state and to the health, safety, welfare and rights of applicants [which] that the State Ombudsman determines to be appropriate;
81	93
82	94		(B) Appropriate action by groups or agencies with jurisdictional authority to deal with problems affecting individual residents, [and the general resident population and applicants] the general resident population of and applicants to long-term care facilities and recipients of home and community-based services in relation to issues concerning applications to long-term care facilities and for home and community-based services; and
83	95
84	96		(C) The enactment of legislative recommendations by the General Assembly and of regulatory recommendations by commissioners of Connecticut state agencies;
85	97
86	98		(9) (A) Provide for training representatives of the office;
87	99
88	100		(B) Promote the development of citizen organizations to participate in the program; and
89	101
90	102		(C) Provide technical support for the development of resident and family councils to protect the well-being and rights of residents of long-term care facilities and recipients of home and community-based services;
91	103
92	104		(10) Coordinate ombudsman services with the protection and advocacy systems for individuals with developmental disabilities and mental illnesses established under (A) Part A of the Development Disabilities Assistance and Bill of Rights Act (42 USC 6001, et seq.), and (B) The Protection and Advocacy for Mentally Ill Individuals Act of 1986 (42 USC 10801 et seq.);
93	105
94	106		(11) Coordinate, to the greatest extent possible, ombudsman services with legal assistance provided under Section 306(a)(2)(C) of the federal Older Americans Act of 1965 [,] (42 USC 3026(a)(2)(C)), as amended from time to time, through the adoption of memoranda of understanding and other means;
95	107
96	108		(12) Create, and periodically update as needed, a training manual for nursing home facilities identified in section 19a-522c that provides guidance on structuring and implementing the training required by said section;
97	109
98	110		(13) Provide services described in this subsection [,] to residents under age sixty living in a long-term care facility, if (A) a majority of the residents of the facility where the younger person resides are over age sixty and (B) such services do not weaken or decrease service to older individuals covered under this chapter;
99	111
100	112		(14) [Implement and administer, on and after July 1, 2014, a pilot program that serves home and community-based care recipients in Hartford County] Provide services described in this subsection to recipients of home and community-based services; and
101	113
102	114		(15) Carry out such other activities and duties as may be required under federal law.
103	115
104	116		Sec. 4. Section 17a-409 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
105	117
106	118		The State Ombudsman is authorized to investigate and make reports and recommendations concerning any act or the failure to act by any agency, official or public employee, with respect to [their] his or her responsibilities and duties in connection with long-term care facilities or home and community-based services, except the courts and [their] court personnel, legislative bodies and [their] personnel and the chief executive of the state and the chief executive's personal staff and all elected officials.
107	119
108	120		Sec. 5. Section 17a-410 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
109	121
110	122		The regional ombudsmen shall, in accordance with the policies and procedures established by the Office of the Long-Term Care Ombudsman:
111	123
112	124		(1) Provide services to protect the health, safety, welfare and rights of residents of long-term care facilities and recipients of home and community-based services;
113	125
114	126		(2) Ensure that residents of long-term care facilities and recipients of home and community-based services in service areas have regular timely access to representatives of the program and timely responses to complaints and requests for assistance;
115	127
116	128		(3) Identify, investigate and resolve complaints made by or on behalf of residents of long-term care facilities and recipients of home and community-based services that relate to action, inaction or decisions that may adversely affect the health, safety, welfare or rights of the residents or recipients or by, or on behalf of, applicants in relation to issues concerning applications to long-term care facilities or for home and community-based services;
117	129
118	130		(4) Represent the interests of residents of long-term care facilities and recipients of home and community-based services and applicants [,] to long-term care facilities or for home and community-based services [in relation to their applications to long-term care facilities,] before government agencies and seek administrative, legal and other remedies to protect the health, safety, welfare and rights of the residents;
119	131
120	132		(5) (A) Review and, if necessary, comment on any existing and proposed laws, regulations and other government policies and actions that pertain to the rights and well-being of residents of long-term care facilities and recipients of home and community-based services and applicants in relation to their applications to long-term care facilities, or for home and community-based services, and (B) facilitate the ability of the public to comment on the laws, regulations, policies and actions;
121	133
122	134		(6) Support the development of resident and family councils; and
123	135
124	136		(7) Carry out other activities that the State Ombudsman determines to be appropriate.
125	137
126	138		Sec. 6. Section 17a-414 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
127	139
128	140		(a) The state agency shall ensure that:
129	141
130	142		(1) Adequate legal counsel is available and is able, without conflict of interest, to: (A) Provide advice and consultation needed to protect the health, safety, welfare and rights of residents of long-term care facilities, recipients of home and community-based services and applicants in relation to their applications to long-term care facilities or for home and community-based services; and (B) assist the [ombudsman] State Ombudsman and representatives of the office in the performance of the official duties of the ombudsman and representatives; and
131	143
132	144		(2) Administrative, legal and other appropriate remedies are pursued on behalf of residents of long-term care facilities, recipients of home and community-based services and applicants in relation to their applications to long-term care facilities or for home and community-based services.
133	145
134	146		(b) The Assistant State Ombudsman, regional ombudsmen and residents' advocates shall be considered state employees under section 4-141 for the purposes of any civil action for damages on account of any act or omission that is not wanton, wilful or malicious and that is within the scope of employment or duties under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532.
135	147
136	148		Sec. 7. Section 17a-415 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
137	149
138	150		(a) The [ombudsman] State Ombudsman and representatives of the office shall have:
139	151
140	152		(1) Access to long-term care facilities and residents;
141	153
142	154		(2) Appropriate access to review the medical and social records of a resident of a long-term care facility or recipient of home and community-based services, if (A) the representative has the permission of the resident or recipient, or the legal representative of the resident or recipient, (B) the resident or recipient is unable to consent to the review and has no legal representative, or (C) access to the records is necessary to investigate a complaint and a legal guardian of the resident or recipient refuses to give permission, a representative of the office has reasonable cause to believe that the guardian is not acting in the best interests of the resident or recipient, and the representative obtains the approval of the [ombudsman] State Ombudsman;
143	155
144	156		(3) Access to the administrative records, policies and documents, to which the residents have, or the general public has access, of long-term care facilities; and
145	157
146	158		(4) Access to and, on request, copies of all licensing and certification records maintained by the state with respect to long-term care facilities and providers of home and community-based services.
147	159
148	160		(b) Any person or entity who wilfully interferes with representatives of the office in the performance of the official duties of the representatives, or any long-term care facility or other entity which retaliates or exacts reprisals with respect to any resident, recipient of services, employee or other person for filing a complaint with, providing information to, or otherwise cooperating with any representative of the office, or long-term care facility which refuses to permit the State Ombudsman or any regional ombudsman or any residents' advocate entry into such facility or any such facility or provider that refuses to cooperate with the State Ombudsman, or any regional ombudsman or any residents' advocate in the carrying out of [their] his or her mandated duties and responsibilities enumerated under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532 or refuses to permit residents, recipients of services or staff to communicate freely with the State Ombudsman or any regional ombudsman or any residents' advocate shall be subject to the penalty prescribed for a class B violation under section 19a-527.
149	161
150	162		(c) In carrying out the duties enumerated in sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532, the State Ombudsman, the Assistant State Ombudsman, the regional ombudsmen and the residents' advocates shall have access to all relevant public records, except [that] records [which] that are confidential to a resident of a long-term care facility or recipient of home and community-based services shall only be divulged with the written consent of the resident or recipient.
151	163
152	164		(d) In the performance of the duties and responsibilities enumerated under sections 17a-405 to 17a-417, inclusive, as amended by this act, 19a-531 and 19a-532, the State Ombudsman, the Assistant State Ombudsman, the regional ombudsmen and the residents' advocates may utilize any other state department, agency or commission, or any other public or private agencies, groups or individuals who are appropriate and who may be available.
153	165
154	166		Sec. 8. Section 17a-417 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
155	167
156	168		The Commissioner on Aging shall require the State Ombudsman to:
157	169
158	170		(1) Prepare an annual report:
159	171
160	172		(A) Describing the activities carried out by the office in the year for which the report is prepared;
161	173
162	174		(B) Containing and analyzing the data collected under section 17a-418, as amended by this act;
163	175
164	176		(C) Evaluating the problems experienced by and the complaints made by or on behalf of residents of long-term care facilities or recipients of home and community-based services;
165	177
166	178		(D) Containing recommendations for (i) improving the quality of the care and life of the residents of long-term care facilities or recipients of home and community-based services, and (ii) protecting the health, safety, welfare and rights of the residents and recipients;
167	179
168	180		(E) (i) Analyzing the success of the program including success in providing services to residents of long-term care facilities and recipients of home and community-based services; and (ii) identifying barriers that prevent the optimal operation of the program; and
169	181
170	182		(F) Providing policy, regulatory and legislative recommendations to solve identified problems, to resolve the complaints, to improve the quality of the care and life of residents of long-term care facilities and recipients of home and community-based services, to protect the health, safety, welfare and rights of residents and recipients and to remove the barriers that prevent the optimal operation of the program.
171	183
172		-	(2) Analyze, comment on and monitor the development and implementation of federal, state and local laws, regulations and other government policies and actions that pertain to long-term care facilities and services, ~~home and community-based services~~ and to the health, safety, welfare and rights of residents in the state, and recommend any changes in such laws, regulations and policies as the office determines to be appropriate.
	184	+	(2) Analyze, comment on and monitor the development and implementation of federal, state and local laws, regulations and other government policies and actions that pertain to long-term care facilities and services, and to the health, safety, welfare and rights of residents in the state, and recommend any changes in such laws, regulations and policies as the office determines to be appropriate.
173	185
174	186		(3) (A) Provide such information as the office determines to be necessary to public and private agencies, legislators and other persons, regarding (i) the problems and concerns of older individuals residing in long-term care facilities or who are the recipients of home and community-based services; and (ii) recommendations related to the problems and concerns; and (B) make available to the public and submit to the federal assistant secretary for aging, the Governor, the General Assembly, the Department of Public Health and other appropriate governmental entities, each report prepared under subdivision (1) of this section.
175	187
176	188		Sec. 9. Section 17a-418 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
177	189
178	190		The state agency shall establish a state-wide uniform system to: (1) Collect and analyze data relating to complaints and conditions in long-term care facilities [and to residents] and complaints concerning home and community-based services for the purpose of identifying and resolving significant problems; and (2) submit the data, on a regular basis to: (A) The Department of Public Health; (B) other state and federal entities that the State Ombudsman determines to be appropriate; and (C) the National Ombudsman Resource Center, established in Section 202(a)(21) of the federal Older Americans Act of 1965, as amended from time to time.
179	191
180	192		Sec. 10. Subdivision (2) of section 17a-419 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
181	193
182	194		(2) Prohibit the disclosure of the identity of any complainant or resident of a long-term care facility or recipient of home and community-based services with respect to whom the office maintains such files or records unless (A) the complainant, [or] resident or recipient, or the legal representative of the complainant, [or] resident or recipient, consents to the disclosure and the consent is given in writing; or (B) (i) the complainant, [or] resident or recipient gives consent orally; and (ii) the consent is documented contemporaneously in a writing made by a representative of the office in accordance with such requirements as the state agency shall establish; or (iii) the disclosure is required by court order.
183	195
184	196		Sec. 11. Subdivision (3) of section 17a-421 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2015):
185	197
186		-	(3) Ensure that the State Ombudsman: (A) Does not have a direct involvement in the licensing or certification of a long-term care facility or of a provider of a long-term care service ~~or a home and community-based service~~; (B) does not have an ownership or investment interest, represented by equity, debt or other financial relationship, in a long-term care facility or a long-term care ~~service or a home and community-based~~ service; (C) is not employed by, or participating in the management of, a long-term care facility or a provider of a home and community-based service; and (D) does not receive, or have the right to receive, directly or indirectly, remuneration, in cash or in kind, under a compensation arrangement with an owner or operator of a long-term care facility or a provider of a home and community-based service; and
	198	+	(3) Ensure that the State Ombudsman: (A) Does not have a direct involvement in the licensing or certification of a long-term care facility or of a provider of a long-term care service; (B) does not have an ownership or investment interest, represented by equity, debt or other financial relationship, in a long-term care facility or a long-term care service; (C) is not employed by, or participating in the management of, a long-term care facility or a provider of a home and community-based service; and (D) does not receive, or have the right to receive, directly or indirectly, remuneration, in cash or in kind, under a compensation arrangement with an owner or operator of a long-term care facility or a provider of a home and community-based service; and
187	199
188	200
189	201
190	202
191	203		This act shall take effect as follows and shall amend the following sections:
192	204		Section 1 July 1, 2015 17a-405
193	205		Sec. 2 July 1, 2015 17a-406(a)
194	206		Sec. 3 July 1, 2015 17a-408
195	207		Sec. 4 July 1, 2015 17a-409
196	208		Sec. 5 July 1, 2015 17a-410
197	209		Sec. 6 July 1, 2015 17a-414
198	210		Sec. 7 July 1, 2015 17a-415
199	211		Sec. 8 July 1, 2015 17a-417
200	212		Sec. 9 July 1, 2015 17a-418
201	213		Sec. 10 July 1, 2015 17a-419(2)
202	214		Sec. 11 July 1, 2015 17a-421(3)
203	215
204	216		This act shall take effect as follows and shall amend the following sections:
205	217
206	218		Section 1
207	219
208	220		July 1, 2015
209	221
210	222		17a-405
211	223
212	224		Sec. 2
213	225
214	226		July 1, 2015
215	227
216	228		17a-406(a)
217	229
218	230		Sec. 3
219	231
220	232		July 1, 2015
221	233
222	234		17a-408
223	235
224	236		Sec. 4
225	237
226	238		July 1, 2015
227	239
228	240		17a-409
229	241
230	242		Sec. 5
231	243
232	244		July 1, 2015
233	245
234	246		17a-410
235	247
236	248		Sec. 6
237	249
238	250		July 1, 2015
239	251
240	252		17a-414
241	253
242	254		Sec. 7
243	255
244	256		July 1, 2015
245	257
246	258		17a-415
247	259
248	260		Sec. 8
249	261
250	262		July 1, 2015
251	263
252	264		17a-417
253	265
254	266		Sec. 9
255	267
256	268		July 1, 2015
257	269
258	270		17a-418
259	271
260	272		Sec. 10
261	273
262	274		July 1, 2015
263	275
264	276		17a-419(2)
265	277
266	278		Sec. 11
267	279
268	280		July 1, 2015
269	281
270	282		17a-421(3)
271	283
272		-	Statement of ~~Legislative Commissioners~~:
	284	+	Statement of Purpose:
273	285
274		-	~~In Section 8(2), "~~home and community-based services~~" was added after "services,"~~ and in ~~Section 11(3)(A) and 11(3)(B), "or a home and community-based service" was added after "service" for internal consistency.~~
	286	+	To expand the duties of the Office of the Long-Term Care Ombudsman to home and community-based services and to establish an Assistant Ombudsman position in the office.
275	287
276		-
277		-
278		-	AGE Joint Favorable Subst. -LCO
279		-
280		-	AGE
281		-
282		-	Joint Favorable Subst. -LCO
	288	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]