LCO \\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955-R01- SB.docx 1 of 8 General Assembly Substitute Bill No. 955 January Session, 2021 AN ACT CONCERNING RE VISIONS TO OBSOLETE PROVISIONS OF THE GENERAL STATUTES AFFECTING THE DEPAR TMENT OF SOCIAL SERVICES. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Subsection (a) of section 16a-41a of the general statutes is 1 repealed and the following is substituted in lieu thereof (Effective July 1, 2 2021): 3 (a) The Commissioner of Social Services shall submit to the joint 4 standing committees of the General Assembly having cognizance of 5 energy planning and activities, appropriations, and human services the 6 following on the implementation of the block grant program authorized 7 under the Low-Income Home Energy Assistance Act of 1981, as 8 amended: 9 (1) Not later than August first, annually, a Connecticut energy 10 assistance program annual plan which establishes guidelines for the use 11 of funds authorized under the Low-Income Home Energy Assistance 12 Act of 1981, as amended, and includes the following: 13 (A) Criteria for determining which households are to receive 14 emergency [and weatherization] assistance; 15 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 2 of 8 (B) A description of systems used to ensure referrals to other energy 16 assistance programs and the taking of simultaneous applications, as 17 required under section 16a-41; 18 (C) A description of outreach efforts; 19 (D) Estimates of the total number of households eligible for assistance 20 under the program and the number of households in which one or more 21 elderly or physically disabled individuals eligible for assistance reside; 22 (E) Design of a basic grant for eligible households that does not 23 discriminate against such households based on the type of energy used 24 for heating; and 25 (F) A payment plan for fuel deliveries beginning November 1, 2018, 26 that ensures a vendor of deliverable fuel who completes deliveries 27 authorized by a community action agency that contracts with the 28 commissioner to administer a fuel assistance program is paid by the 29 community action agency not later than thirty business days after the 30 date the community action agency receives an authorized fuel slip or 31 invoice for payment from the vendor; 32 (2) Not later than January thirtieth, annually, a report covering the 33 preceding months of the program year, including: 34 (A) In each community action agency geographic area, [and 35 Department of Social Services region,] the number of fuel assistance 36 applications filed, approved and denied, and the number of emergency 37 assistance requests made, approved and denied; [and the number of 38 households provided weatherization assistance;] 39 (B) In each such area, [and district,] the total amount of fuel [,] and 40 emergency [and weatherization] assistance, itemized by such type of 41 assistance, and total expenditures to date; 42 (C) For each state-wide office of each state agency administering the 43 program [,] and each community action agency, [and each Department 44 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 3 of 8 of Social Services region,] administrative expenses under the program, 45 by line item, and an estimate of outreach expenditures; and 46 (D) A list of community action agencies that failed to make timely 47 payments to vendors of deliverable fuel in the Connecticut energy 48 assistance program and the steps taken by the commissioner to ensure 49 future timely payments by such agencies; and 50 (3) Not later than November first, annually, a report covering the 51 preceding twelve calendar months, including: 52 (A) In each community action agency geographic area, [and 53 Department of Social Services region,] (i) seasonal totals for the 54 categories of data submitted under subdivision (1) of this subsection, (ii) 55 the number of households receiving fuel assistance in which elderly or 56 physically disabled individuals reside, and (iii) the average combined 57 benefit level of fuel, emergency and renter assistance; 58 [(B) Types of weatherization assistance provided; 59 (C) Percentage of weatherization assistance provided to tenants;] 60 [(D)] (B) The number of homeowners and tenants whose heat or total 61 energy costs are not included in their rent receiving fuel and emergency 62 assistance under the program by benefit level; 63 [(E)] (C) The number of homeowners and tenants whose heat is 64 included in their rent and who are receiving assistance, by benefit level; 65 and 66 [(F)] (D) The number of households receiving assistance, by energy 67 type and total expenditures for each energy type. 68 Sec. 2. Subsection (d) of section 17b-8 of the general statutes is 69 repealed and the following is substituted in lieu thereof (Effective July 1, 70 2021): 71 (d) The commissioner shall include with any waiver application or 72 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 4 of 8 proposed amendment submitted to the federal government pursuant to 73 this section: (1) Any written comments received pursuant to subsection 74 (c) of this section; and (2) [a complete transcript of the joint standing 75 committee proceedings held pursuant to subsection (a) of this section, 76 including] any additional written comments submitted to the joint 77 standing committees at such proceedings. The joint standing 78 committees shall transmit any such materials to the commissioner for 79 inclusion with any such waiver application or proposed amendment. 80 Sec. 3. Subsection (b) of section 17b-59a of the general statutes is 81 repealed and the following is substituted in lieu thereof (Effective July 1, 82 2021): 83 (b) The Commissioner of Social Services, in consultation with the 84 executive director of the Office of Health Strategy, established under 85 section 19a-754a, shall (1) develop, throughout the Departments of 86 Developmental Services, Public Health, Correction, Children and 87 Families, Veterans Affairs and Mental Health and Addiction Services, 88 uniform management information, uniform statistical information, 89 uniform terminology for similar facilities, and uniform electronic health 90 information technology standards, [and uniform regulations for the 91 licensing of human services facilities,] (2) plan for increased 92 participation of the private sector in the delivery of human services, (3) 93 provide direction and coordination to federally funded programs in the 94 human services agencies and recommend uniform system 95 improvements and reallocation of physical resources and designation of 96 a single responsibility across human services agencies lines to facilitate 97 shared services and eliminate duplication. 98 Sec. 4. Section 17b-306a of the general statutes is repealed and the 99 following is substituted in lieu thereof (Effective July 1, 2021): 100 (a) The Commissioner of Social Services, in collaboration with the 101 Commissioners of Public Health and Children and Families, shall 102 establish a child health quality improvement program for the purpose 103 of promoting the implementation of evidence-based strategies by 104 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 5 of 8 providers participating in the HUSKY Health program to improve the 105 delivery of and access to children's health services. Such strategies shall 106 focus on physical, dental and mental health services and shall include, 107 but need not be limited to: (1) Methods for early identification of 108 children with special health care needs; (2) integration of care 109 coordination and care planning into children's health services; (3) 110 implementation of standardized data collection to measure 111 performance improvement; and (4) implementation of family-centered 112 services in patient care, including, but not limited to, the development 113 of parent-provider partnerships. The Commissioner of Social Services 114 shall seek the participation of public and private entities that are 115 dedicated to improving the delivery of health services, including 116 medical, dental and mental health providers, academic professionals 117 with experience in health services research and performance 118 measurement and improvement, and any other entity deemed 119 appropriate by the Commissioner of Social Services, to promote such 120 strategies. The commissioner shall ensure that such strategies reflect 121 new developments and best practices in the field of children's health 122 services. As used in this section, "evidence-based strategies" means 123 policies, procedures and tools that are informed by research and 124 supported by empirical evidence, including, but not limited to, research 125 developed by organizations such as the American Academy of 126 Pediatrics, the American Academy of Family Physicians, the National 127 Association of Pediatric Nurse Practitioners and the Institute of 128 Medicine. 129 (b) Not later than July 1, 2008, and annually thereafter, the 130 Commissioner of Social Services shall report, in accordance with section 131 11-4a, to the joint standing committees of the General Assembly having 132 cognizance of matters relating to human services, public health and 133 appropriations, and to the Council on Medical Assistance Program 134 Oversight on (1) the implementation of any strategies developed 135 pursuant to subsection (a) of this section, and (2) the efficacy of such 136 strategies in improving the delivery of and access to health services for 137 children enrolled in the HUSKY Health program. 138 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 6 of 8 [(c) The Commissioner of Social Services, in collaboration with the 139 Council on Medical Assistance Program Oversight, shall, subject to 140 available appropriations, prepare, annually, a report concerning health 141 care choices under HUSKY A. Such report shall include, but not be 142 limited to, a comparison of the performance of each managed care 143 organization, the primary care case management program and other 144 member service delivery choices. The commissioner shall provide a 145 copy of each report to all HUSKY A members.] 146 Sec. 5. Subsection (a) of section 17b-349 of the general statutes is 147 repealed and the following is substituted in lieu thereof (Effective July 1, 148 2021): 149 (a) The rates paid by the state to community health centers [and 150 freestanding medical clinics] participating in the Medicaid program 151 may be adjusted annually on the basis of the cost reports submitted to 152 the Commissioner of Social Services. [, except that rates effective July 1, 153 1989, shall remain in effect through June 30, 1990.] The Department of 154 Social Services may develop an alternative payment methodology to 155 replace the encounter-based reimbursement system. Such methodology 156 shall be approved by the joint standing committees of the General 157 Assembly having cognizance of matters relating to human services and 158 appropriations and the budgets of state agencies. Until such 159 methodology is implemented, the Department of Social Services shall 160 distribute supplemental funding, within available appropriations, to 161 federally qualified health centers based on cost, volume and quality 162 measures as determined by the Commissioner of Social Services. (1) 163 Beginning with the one-year rate period commencing on October 1, 164 2012, and annually thereafter, the Commissioner of Social Services may 165 add to a community health center's rates, if applicable, a capital cost rate 166 adjustment that is equivalent to the center's actual or projected year-to-167 year increase in total allowable depreciation and interest expenses 168 associated with major capital projects divided by the projected service 169 visit volume. For the purposes of this subsection, "capital costs" means 170 expenditures for land or building purchases, fixed assets, movable 171 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 7 of 8 equipment, capitalized financing fees and capitalized construction 172 period interest and "major capital projects" means projects with costs 173 exceeding two million dollars. The commissioner may revise such 174 capital cost rate adjustment retroactively based on actual allowable 175 depreciation and interest expenses or actual service visit volume for the 176 rate period. (2) The commissioner shall establish separate capital cost 177 rate adjustments for each Medicaid service provided by a center. (3) The 178 commissioner shall not grant a capital cost rate adjustment to a 179 community health center for any depreciation or interest expenses 180 associated with capital costs that were disapproved by the federal 181 Department of Health and Human Services or another federal or state 182 government agency with capital expenditure approval authority related 183 to health care services. (4) The commissioner may allow actual debt 184 service in lieu of allowable depreciation and interest expenses 185 associated with capital items funded with a debt obligation, provided 186 debt service amounts are deemed reasonable in consideration of the 187 interest rate and other loan terms. (5) The commissioner shall 188 implement policies and procedures necessary to carry out the 189 provisions of this subsection while in the process of adopting such 190 policies and procedures in regulation form, provided notice of intent to 191 adopt such regulations is [published in the Connecticut Law Journal not 192 later than twenty days after implementation] posted on the 193 eRegulations System prior to adopting the policies and procedures. 194 Such policies and procedures shall be valid until the time final 195 regulations are effective. 196 Sec. 6. Subsection (n) of section 38a-479aa of the general statutes is 197 repealed and the following is substituted in lieu thereof (Effective July 1, 198 2021): 199 (n) The requirements of subsections (h) and (i) of this section shall not 200 apply to a consortium of federally qualified health centers funded by 201 the state, providing services only to recipients of programs 202 administered by the Department of Social Services. [The Commissioner 203 of Social Services shall adopt regulations, in accordance with chapter 54, 204 Substitute Bill No. 955 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2021SB-00955- R01-SB.docx } 8 of 8 to establish criteria to certify any such federally qualified health center, 205 including, but not limited to, minimum reserve fund requirements.] 206 Sec. 7. Section 17b-608 of the general statutes is repealed and the 207 following is substituted in lieu thereof (Effective July 1, 2021): 208 For the purposes of [sections 17b-609 and 17b-610] section 17b-609, 209 "persons with disabilities" means persons having disabilities which (1) 210 are attributable to a mental or physical impairment or a combination of 211 mental and physical impairments; (2) are likely to continue indefinitely; 212 (3) result in functional limitations in one or more of the following areas 213 of major life activity: Self care, receptive and expressive language, 214 learning, mobility, self-direction, capacity for independent living or 215 economic self-sufficiency; and (4) reflect the person's need for a 216 combination and sequence of special, interdisciplinary or generic care, 217 treatment or other services which are of lifelong or extended duration 218 and individually planned and coordinated. 219 Sec. 8. Sections 17b-184, 17b-274a and 17b-610 of the general statutes 220 are repealed. (Effective July 1, 2021) 221 This act shall take effect as follows and shall amend the following sections: Section 1 July 1, 2021 16a-41a(a) Sec. 2 July 1, 2021 17b-8(d) Sec. 3 July 1, 2021 17b-59a(b) Sec. 4 July 1, 2021 17b-306a Sec. 5 July 1, 2021 17b-349(a) Sec. 6 July 1, 2021 38a-479aa(n) Sec. 7 July 1, 2021 17b-608 Sec. 8 July 1, 2021 Repealer section Statement of Legislative Commissioners: The title of the bill was changed. HS Joint Favorable Subst.