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General Assembly Governor's Bill No. 5040
February Session, 2022
LCO No. 642
Referred to Committee on HUMAN SERVICES
Introduced by:
Request of the Governor Pursuant
to Joint Rule 9
AN ACT CONCERNING THE GOVERNOR'S BUDGET
RECOMMENDATIONS FOR HUMAN SERVICES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Section 19a-7d of the 2022 supplement to the general 1
statutes is repealed and the following is substituted in lieu thereof 2
(Effective from passage): 3
(a) [Not later than January 1, 2022, the] The Commissioner of Public 4
Health shall establish, within available resources, a program to provide 5
three-year grants to community-based providers of primary care 6
services in order to expand access to health care for the uninsured. The 7
grants may be awarded to community-based providers of primary care 8
for (1) funding for direct services, (2) recruitment and retention of 9
primary care clinicians and registered nurses through subsidizing of 10
salaries or through a loan repayment program, and (3) capital 11
expenditures. The community-based providers of primary care under 12
the direct service program shall provide, or arrange access to, primary 13 Governor's Bill No. 5040
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and preventive services, behavioral health services, referrals to specialty 14
services, including rehabilitative and mental health services, inpatient 15
care, prescription drugs, basic diagnostic laboratory services, health 16
education and outreach to alert people to the availability of services. 17
Primary care clinicians and registered nurses participating in the state 18
loan repayment program or receiving subsidies shall provide services 19
to the uninsured based on a sliding fee schedule, provide free care if 20
necessary, accept Medicare assignment and participate as Medicaid 21
providers, or provide nursing services in school-based health centers 22
and expanded school health sites, as such terms are defined in section 23
19a-6r. The commissioner may adopt regulations, in accordance with 24
the provisions of chapter 54, to establish eligibility criteria, services to 25
be provided by participants, the sliding fee schedule, reporting 26
requirements and the loan repayment program. For the purposes of this 27
section, "primary care clinicians" includes family practice physicians, 28
general practice osteopaths, obstetricians and gynecologists, internal 29
medicine physicians, pediatricians, dentists, certified nurse midwives, 30
advanced practice registered nurses, physician assistants, [and] dental 31
hygienists, psychiatrists, psychologists, licensed clinical social workers, 32
licensed marriage and family therapists and licensed professional 33
counselors. 34
(b) Funds appropriated for the state loan repayment program shall 35
not lapse until fifteen months following the end of the fiscal year for 36
which such funds were appropriated. 37
Sec. 2. Section 36 of public act 21-2 of the June special session is 38
repealed and the following is substituted in lieu thereof (Effective from 39
passage): 40
(a) As used in this section: 41
(1) "Community action agency" means a public or private nonprofit 42
agency which has previously been designated by and authorized to 43
accept funds from the federal Community Services Administration for 44
community action agencies under the Economic Opportunity Act of 45 Governor's Bill No. 5040
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1964, or a successor agency established pursuant to section 17b-892 of 46
the general statutes; 47
(2) "Community health worker" means a public health outreach 48
professional with an in-depth understanding of the experience, 49
language, culture and socioeconomic needs of the community and who 50
provides a range of services, including, but not limited to, outreach, 51
engagement, education, coaching, informal counseling, social support, 52
advocacy, care coordination, research related to social determinants of 53
health and basic screenings and assessments of any risks associated with 54
social determinants of health; and 55
(3) "COVID-19" means the respiratory disease designated by the 56
World Health Organization on February 11, 2020, as coronavirus 2019, 57
and any related mutation thereof recognized by said organization as a 58
communicable respiratory disease. 59
(b) The Department of [Public Health] Social Services shall establish 60
a community health worker grant program. The purpose of such 61
program shall be to provide grants to community action agencies that 62
employ community health workers who provide a range of services to 63
persons adversely affected by the COVID-19 pandemic. The department 64
may enter into an agreement, pursuant to chapter 55a of the general 65
statutes, with a person, firm, corporation or other entity to operate such 66
program. 67
(c) The Department of [Public Health] Social Services shall publish on 68
its Internet web site a notice of grant availability for the period 69
beginning on [the effective date of this section] June 23, 2021, and ending 70
on June 30, [2023] 2024. 71
(d) Each community action agency applying for a grant under this 72
section shall submit an application in such form and manner as 73
prescribed by the Commissioner of [Public Health] Social Services. Each 74
application shall include the following information: (1) The location of 75
the principal place of business of the applicant; (2) the number of 76
community health workers employed by the applicant [or that] and the 77 Governor's Bill No. 5040
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number of community health workers the applicant seeks to employ 78
under the grant and the range of services provided or to be provided by 79
such community health workers; (3) an explanation of the intended use 80
of the grant being applied for; (4) strategies for integrating community 81
health workers into an individual's care delivery team, including, but 82
not limited to, the capacity to address health care and social services 83
needs; and [(4)] (5) such other information that the commissioner deems 84
necessary. 85
(e) The Department of [Public Health] Social Services shall review all 86
grant applications received under the program and determine which 87
applications are eligible for funding. Criteria for such determinations 88
shall be established by the department and included in the notice of 89
grant availability described in subsection (c) of this section. 90
(f) The amount of any grant issued to a community action agency 91
pursuant to this section shall not exceed thirty thousand dollars 92
annually per community health worker employed by such agency and 93
the total amount of grants issued to community action agencies in the 94
aggregate shall not exceed six million dollars. No grant shall be issued 95
pursuant to this section after June 30, [2023] 2024. 96
[(g) (1) Not later than January 1, 2022, the Commissioner of Public 97
Health shall report, in accordance with the provisions of section 11-4a 98
of the general statutes, to the joint standing committee of the General 99
Assembly having cognizance of matters relating to public health and 100
human services regarding the progress of the program and including 101
any requisite legislative proposals to accomplish the goals of the 102
program.] 103
[(2)] (g) Not later than January 1, 2024, the Commissioner of [Public 104
Health] Social Services shall report, in accordance with the provisions of 105
section 11-4a of the general statutes, on the community health worker 106
grant program to the joint standing committees of the General Assembly 107
having cognizance of matters relating to public health and human 108
services. Such report shall include the following data regarding the 109 Governor's Bill No. 5040
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program: [(A)] (1) The number of grants provided and the amount of 110
such grants; [(B)] (2) the identities of the community action agencies that 111
received such grants; [(C)] (3) the intended use of each grant provided, 112
as described by the community action agency pursuant to subdivision 113
(3) of subsection (d) of this section; [(D)] (4) the number of community 114
health workers employed by each community action agency that 115
received a grant at the time such agency received such grant and 116
information regarding the services provided by such community health 117
workers; and [(E)] (5) the number of community health workers 118
employed by each community action agency that received a grant at the 119
conclusion of the program and information regarding the services 120
provided by such community health workers. 121
Sec. 3. Section 37 of public act 21-2 of the June special session is 122
repealed and the following is substituted in lieu thereof (Effective from 123
passage): 124
The sum of $3,000,000 allocated in section 41 of special act 21-15 and 125
section 306 of [this act] public act 21-2 of the June special session, to the 126
Department of Public Health, for Community Health Workers, for each 127
of the fiscal years ending June 30, 2022, and June 30, 2023, shall be for 128
the purposes of the program established pursuant to section 36 of [this 129
act] public act 21-2 of the June special session, as amended by this act. 130
The Department of Public Health shall transfer such funds to the 131
Department of Social Services. 132
Sec. 4. Section 321 of public act 21-2 of the June special session is 133
repealed and the following is substituted in lieu thereof (Effective from 134
passage): 135
The Commissioner of Social Services shall, within the ten million 136
dollars in federal funds allocated to the Department of Social Services 137
pursuant to section 1 of special act 21-1, in accordance with the 138
provisions of Subtitle M of Title IX of the American Rescue Plan Act of 139
2021, P.L. 117-2, as amended from time to time, provide temporary 140
financial relief to nursing home facilities. [Grant allocations shall be 141 Governor's Bill No. 5040
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made based on the per cent difference between the issued and calculated 142
reimbursement rate. The commissioner, within the available ten million 143
dollars in federal funding allocated to the department for this purpose, 144
shall issue one-time grants subject to a pro rata adjustment based on 145
available funding.] 146
Sec. 5. Section 325 of public act 21-2 of the June special session is 147
repealed and the following is substituted in lieu thereof (Effective from 148
passage): 149
Notwithstanding the provisions of section 17b-340 of the general 150
statutes, for the fiscal years ending June 30, 2022, and June 30, 2023, the 151
Commissioner of Social Services shall, for the purposes of providing 152
pandemic-related support, increase the minimum per diem, per bed rate 153
to five hundred one dollars for a residential facility licensed pursuant to 154
section 17a-227 of the general statutes and certified to participate in the 155
Title XIX Medicaid program as an intermediate care facility for 156
individuals with intellectual disability. 157
Sec. 6. Section 17b-112 of the 2022 supplement to the general statutes 158
is repealed and the following is substituted in lieu thereof (Effective from 159
passage): 160
(a) The Department of Social Services shall administer a temporary 161
family assistance program under which cash assistance shall be 162
provided to eligible families in accordance with the temporary 163
assistance for needy families program, established pursuant to the 164
Personal Responsibility and Work Opportunity Reconciliation Act of 165
1996. The Commissioner of Social Services may operate portions of the 166
temporary family assistance program as a solely state-funded program, 167
separate from the federal temporary assistance for needy families 168
program, if the commissioner determines that doing so will enable the 169
state to avoid fiscal penalties under the temporary assistance for needy 170
families program. Families receiving assistance under the solely state-171
funded portion of the temporary family assistance program shall be 172
subject to the same conditions of eligibility as those receiving assistance 173 Governor's Bill No. 5040
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under the federal temporary assistance for needy families program. 174
Under the temporary family assistance program, benefits shall be 175
provided to a family for not longer than twenty-one months, except as 176
provided in subsections (b) and (c) of this section. For the purpose of 177
calculating said twenty-one-month time limit, months of assistance 178
received on and after January 1, 1996, pursuant to time limits under the 179
aid to families with dependent children program, shall be included. For 180
purposes of this section, "family" means one or more individuals who 181
apply for or receive assistance together under the temporary family 182
assistance program. If the commissioner determines that federal law 183
allows individuals not otherwise in an eligible covered group for the 184
temporary family assistance program to become covered, such family 185
may also, at the discretion of the commissioner, be composed of (1) a 186
pregnant woman, or (2) a parent, both parents or other caretaker relative 187
and at least one child who is under the age of eighteen, or who is under 188
the age of nineteen and a full-time student in a secondary school or its 189
equivalent. A caretaker relative shall be related to the child or children 190
by blood, marriage or adoption or shall be the legal guardian of such a 191
child or pursuing legal proceedings necessary to achieve guardianship. 192
If the commissioner elects to allow state eligibility consistent with any 193
change in federal law, the commissioner may administratively transfer 194
any qualifying family cases under the cash assistance portion of the 195
state-administered general assistance program to the temporary family 196
assistance program without regard to usual eligibility and enrollment 197
procedures. If such families become an ineligible coverage group under 198
the federal law, the commissioner shall administratively transfer such 199
families back to the cash assistance portion of the state-administered 200
general assistance program without regard to usual eligibility and 201
enrollment procedures to the degree that such families are eligible for 202
the state program. 203
(b) The Commissioner of Social Services shall exempt a family from 204
such time-limited benefits for circumstances including, but not limited 205
to: (1) A family with a needy caretaker relative who is incapacitated or 206
of an advanced age, as defined by the commissioner, if there is no other 207 Governor's Bill No. 5040
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nonexempt caretaker relative in the household; (2) a family with a needy 208
caretaker relative who is needed in the home because of the incapacity 209
of another member of the household, if there is no other nonexempt 210
caretaker relative in the household; (3) a family with a caretaker relative 211
who is not legally responsible for the dependent children in the 212
household if such relative's needs are not considered in calculating the 213
amount of the benefit and there is no other nonexempt caretaker relative 214
in the household; (4) a family with a caretaker relative caring for a child 215
who is under one year of age if there is no other nonexempt caretaker 216
relative in the household; (5) a family with a pregnant or postpartum 217
caretaker relative if a physician has indicated that such relative is unable 218
to work and there is no other nonexempt caretaker relative in the 219
household; (6) a family with a caretaker relative determined by the 220
commissioner to be unemployable and there is no other nonexempt 221
caretaker relative in the household; and (7) minor parents attending and 222
satisfactorily completing high school or high school equivalency 223
programs. 224
(c) A family who is subject to time-limited benefits may petition the 225
Commissioner of Social Services for six-month extensions of such 226
benefits. The commissioner shall grant not more than two extensions to 227
such family who has made a good faith effort to comply with the 228
requirements of the program and despite such effort has a total family 229
income at a level below the payment standard, or has encountered 230
circumstances preventing employment including, but not limited to: (1) 231
Domestic violence or physical harm to such family's children; or (2) 232
other circumstances beyond such family's control. The commissioner 233
shall disregard ninety dollars of earned income in determining 234
applicable family income. The commissioner may grant a subsequent 235
six-month extension if each adult in the family meets one or more of the 236
following criteria: (A) The adult is precluded from engaging in 237
employment activities due to domestic violence or another reason 238
beyond the adult's control; (B) the adult has two or more substantiated 239
barriers to employment including, but not limited to, the lack of 240
available child care, substance abuse or addiction, severe mental or 241 Governor's Bill No. 5040
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physical health problems, one or more severe learning disabilities, 242
domestic violence or a child who has a serious physical or behavioral 243
health problem; (C) the adult is working thirty-five or more hours per 244
week, is earning at least the minimum wage and continues to earn less 245
than the family's temporary family assistance payment standard; or (D) 246
the adult is employed and works less than thirty-five hours per week 247
due to (i) a documented medical impairment that limits the adult's 248
hours of employment, provided the adult works the maximum number 249
of hours that the medical condition permits, or (ii) the need to care for a 250
disabled member of the adult's household, provided the adult works the 251
maximum number of hours the adult's caregiving responsibilities 252
permit. Families receiving temporary family assistance shall be notified 253
by the department of the right to petition for such extensions. 254
Notwithstanding the provisions of this section, the commissioner shall 255
not provide benefits under the state's temporary family assistance 256
program to a family that is subject to the twenty-one month benefit limit 257
and has received benefits beginning on or after October 1, 1996, if such 258
benefits result in that family's receiving more than sixty months of time-259
limited benefits unless that family experiences domestic violence, as 260
defined in Section 402(a)(7)(B), P.L. 104-193. For the purpose of 261
calculating said sixty-month limit: (I) A month shall count toward the 262
limit if the family receives assistance for any day of the month, provided 263
any months of temporary family assistance received during the public 264
health emergency declared by Governor Ned Lamont related to the 265
COVID-19 pandemic shall not be included, and (II) a month in which a 266
family receives temporary assistance for needy families benefits that are 267
issued from a jurisdiction other than Connecticut shall count toward the 268
limit. 269
(d) Under said program, no family shall be eligible that has total gross 270
earnings exceeding the federal poverty level, however, in the calculation 271
of the benefit amount for eligible families and previously eligible 272
families that become ineligible temporarily because of receipt of 273
workers' compensation benefits by a family member who subsequently 274
returns to work immediately after the period of receipt of such benefits, 275 Governor's Bill No. 5040
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earned income shall be disregarded up to the federal poverty level. 276
Except when determining eligibility for a six-month extension of 277
benefits pursuant to subsection (c) of this section, the commissioner 278
shall disregard the first fifty dollars per month of income attributable to 279
current child support that a family receives in determining eligibility 280
and benefit levels for temporary family assistance. Any current child 281
support in excess of fifty dollars per month collected by the department 282
on behalf of an eligible child shall be considered in determining 283
eligibility but shall not be considered when calculating benefits and 284
shall be taken as reimbursement for assistance paid under this section, 285
except that when the current child support collected exceeds the family's 286
monthly award of temporary family assistance benefits plus fifty 287
dollars, the current child support shall be paid to the family and shall be 288
considered when calculating benefits. 289
(e) A family receiving assistance under said program shall cooperate 290
with child support enforcement, under title IV-D of the Social Security 291
Act. A family shall be ineligible for benefits for failure to cooperate with 292
child support enforcement. 293
(f) A family leaving assistance at the end of (1) said twenty-one-294
month time limit, including a family with income above the payment 295
standard, or (2) the sixty-month limit shall have an interview for the 296
purpose of being informed of services that may continue to be available 297
to such family, including employment services available through the 298
Labor Department. Such interview shall include (A) a determination of 299
benefits available to the family provided by the Department of Social 300
Services; and (B) a determination of whether such family is eligible for 301
supplemental nutrition assistance or Medicaid. Information and 302
referrals shall be made to such a family for services and benefits 303
including, but not limited to, the earned income tax credit, rental 304
subsidies emergency housing, employment services and energy 305
assistance. 306
[(g) Notwithstanding section 17b-104, commencing on July 1, 2023, 307
the Commissioner of Social Services shall provide an annual cost-of-308 Governor's Bill No. 5040
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living adjustment in temporary family assistance benefits equal to the 309
most recent percentage increase in the consumer price index for urban 310
consumers whenever funds appropriated for temporary family 311
assistance lapse at the close of any fiscal year and such adjustment has 312
not otherwise been included in the budget for the assistance program, 313
provided the increase would not create a budget deficiency in 314
succeeding years. The commissioner shall provide a prorated benefit 315
increase from such available lapsed funds in any fiscal year when such 316
funds are not sufficient to cover a cost-of-living adjustment in 317
accordance with this subsection.] 318
[(h)] (g) An applicant or recipient of temporary family assistance who 319
is adversely affected by a decision of the Commissioner of Social 320
Services may request and shall be provided a hearing in accordance 321
with section 17b-60. 322
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 19a-7d
Sec. 2 from passage PA 21-2 of the June Sp.
Sess., Sec. 36
Sec. 3 from passage PA 21-2 of the June Sp.
Sess., Sec. 37
Sec. 4 from passage PA 21-2 of the June Sp.
Sess., Sec. 321
Sec. 5 from passage PA 21-2 of the June Sp.
Sess., Sec. 325
Sec. 6 from passage 17b-112
Statement of Purpose:
To implement the Governor's budget recommendations.
[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.]