OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
sSB-1030
AN ACT CONCERNING LONG -TERM CARE FACILITIES.
Primary Analyst: ES 4/13/21
Contributing Analyst(s): RDP, LD, CP
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 22 $ FY 23 $
Public Health, Dept. GF - Cost 5.4 million 2.4 million
State Comptroller - Fringe
Benefits
1
GF - Cost 82,130 84,600
Social Services, Dept. GF - Cost See Below See Below
Note: GF=General Fund
Municipal Impact: None
Explanation
The bill results in cost to the Department of Public Health (DPH)
and the Department of Social Services (DSS) associated with
requirements for long-term care facilities to build infection control
capacity and new minimum staffing levels for nursing homes.
Section 1 results in a cost of approximately $96,340 in FY 22 and
$96,170 to DPH (with associated fringe of $38,160 in FY 22 and $39,310
in FY 23) for infection control training. The Healthcare-Associated
Infections & Antimicrobial Resistance (HAI-AR) Program provides
technical assistance to healthcare facilities in infection control and
prevention. HAI-AR will need an additional Nurse Consultant to
support technical assistance with infection control to allow long-term
care facilities to comply with the bill.
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 41.3% of payroll in FY 22 and FY 23. 2021SB-01030-R000457-FN.DOCX Page 2 of 3
Section 3 results in a cost associated with requiring DPH to
maintain a 90-day stockpile of personal protective equipment (PPE)
that will be used to supply long-term care facilities during a public
health emergency. Funding of approximately $106,460 in FY 22 and
$109,660 in FY 23 (with associated fringe of $43,970 in FY 22 and
$45,290 in FY 23) will support two Material Storage staff to help
manage PPE. DPH will also incur costs of approximately $3.2 million
in FY 22 and $200,000 in FY 23 associated with PPE supplies, storage,
and an inventory management system. In addition, the bill results in a
cost of approximately $2 million in FY 22 and FY 23 to support a
maintenance contract with a vendor to resupply the needed PPE prior
to expiration.
Section 13 results in a cost to DSS associated with revising nursing
home staffing levels and eliminating the distinction between a chronic
and convalescent nursing home and a rest home with nursing
supervision.
Staffing ratio requirements will result in a significant cost to DSS to
the extent nursing home staffing costs are reflected in future Medicaid
payments. The bill specifies that a total of 4.1 hours of direct care be
provided per resident per day, including 3.75 hours by a registered
nurse (RN), 0.54 hours by a licensed practical nurse (LPN), and 2.81
hours by a certified nurse's assistant (CAN).
Based on 2019 nursing home staffing data, none of the
approximately 200 homes can meet the bill's requirements for RNs
(with an average of 0.70 hours of direct care provided per resident per
day). Approximately 10% of homes do not meet the LPN staffing
requirements, while approximately 80% do not meet the requirements
for CNAs. The cost for nursing homes to staff at the proposed levels
will depend on the actual number and level of staff required and their
associated wages but is anticipated to be at least $200 million.
The Out Years
The annualized ongoing fiscal impact identified above would 2021SB-01030-R000457-FN.DOCX Page 3 of 3
continue into the future subject to inflation.