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General Assembly Raised Bill No. 5431
February Session, 2022
LCO No. 2948
Referred to Committee on APPROPRIATIONS
Introduced by:
(APP)
AN ACT CONCERNING FUNDING RECEIVED BY THE STATE UNDER
THE FEDERAL AMERICAN RESCUE PLAN ACT.
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statutes is repealed and the following is substituted in lieu thereof 2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
and preventive services, behavioral health services, referrals to specialty 14
services, including rehabilitative and mental health services, inpatient 15 Raised Bill No. 5431
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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
1964, or a successor agency established pursuant to section 17b-892 of 46
the general statutes; 47 Raised Bill No. 5431
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(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
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 Raised Bill No. 5431
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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, or planned to be 93
employed by, such agency and the total amount of grants issued to 94
community action agencies in the aggregate shall not exceed six million 95
dollars. No grant shall be issued pursuant to this section after June 30, 96
[2023] 2024. 97
[(g) (1) Not later than January 1, 2022, the Commissioner of Public 98
Health shall report, in accordance with the provisions of section 11-4a 99
of the general statutes, to the joint standing committee of the General 100
Assembly having cognizance of matters relating to public health and 101
human services regarding the progress of the program and including 102
any requisite legislative proposals to accomplish the goals of the 103
program.] 104
[(2)] (g) Not later than January 1, 2024, the Commissioner of [Public 105
Health] Social Services shall report, in accordance with the provisions of 106
section 11-4a of the general statutes, on the community health worker 107
grant program to the joint standing committees of the General Assembly 108
having cognizance of matters relating to public health and human 109
services. Such report shall include the following data regarding the 110
program: [(A)] (1) The number of grants provided and the amount of 111 Raised Bill No. 5431
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such grants; [(B)] (2) the identities of the community action agencies that 112
received such grants; [(C)] (3) the intended use of each grant provided, 113
as described by the community action agency pursuant to subdivision 114
(3) of subsection (d) of this section; [(D)] (4) the number of community 115
health workers employed by each community action agency that 116
received a grant at the time such agency received such grant and 117
information regarding the services provided by such community health 118
workers; and [(E)] (5) the number of community health workers 119
employed by each community action agency that received a grant at the 120
conclusion of the program and information regarding the services 121
provided by such community health workers. 122
Sec. 3. Section 37 of public act 21-2 of the June special session is 123
repealed and the following is substituted in lieu thereof (Effective from 124
passage): 125
The sum of $3,000,000 allocated in section 41 of special act 21-15, [and] 126
as amended by section 306 of [this act] public act 21-2 of the June special 127
session, to the Department of Public Health, for Community Health 128
Workers, for each of the fiscal years ending June 30, 2022, and June 30, 129
2023, shall be for the purposes of the program established pursuant to 130
section 36 of [this act] public act 21-2 of the June special session, as 131
amended by this act. The Department of Public Health shall transfer 132
such funds to the Department of Social Services. 133
Sec. 4. Section 321 of public act 21-2 of the June special session is 134
repealed and the following is substituted in lieu thereof (Effective from 135
passage): 136
The Commissioner of Social Services shall, within the ten million 137
dollars in federal funds allocated to the Department of Social Services 138
pursuant to section 1 of special act 21-1, as amended by this act, in 139
accordance with the provisions of Subtitle M of Title IX of the American 140
Rescue Plan Act of 2021, P.L. 117-2, as amended from time to time, 141
provide temporary financial relief to nursing home facilities. [Grant 142
allocations shall be made based on the per cent difference between the 143 Raised Bill No. 5431
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issued and calculated reimbursement rate. The commissioner, within 144
the available ten million dollars in federal funding allocated to the 145
department for this purpose, shall issue one-time grants subject to a pro 146
rata adjustment based on available funding.] 147
Sec. 5. Section 325 of public act 21-2 of the June special session is 148
repealed and the following is substituted in lieu thereof (Effective from 149
passage): 150
Notwithstanding the provisions of section 17b-340 of the general 151
statutes, for the fiscal years ending June 30, 2022, and June 30, 2023, the 152
Commissioner of Social Services shall, for the purposes of providing 153
pandemic-related support, increase the minimum per diem, per bed rate 154
to five hundred one dollars for a residential facility licensed pursuant to 155
section 17a-227 of the general statutes and certified to participate in the 156
Title XIX Medicaid program as an intermediate care facility for 157
individuals with intellectual disability. 158
Sec. 6. Section 17b-112 of the 2022 supplement to the general statutes 159
is repealed and the following is substituted in lieu thereof (Effective from 160
passage): 161
(a) The Department of Social Services shall administer a temporary 162
family assistance program under which cash assistance shall be 163
provided to eligible families in accordance with the temporary 164
assistance for needy families program, established pursuant to the 165
Personal Responsibility and Work Opportunity Reconciliation Act of 166
1996. The Commissioner of Social Services may operate portions of the 167
temporary family assistance program as a solely state-funded program, 168
separate from the federal temporary assistance for needy families 169
program, if the commissioner determines that doing so will enable the 170
state to avoid fiscal penalties under the temporary assistance for needy 171
families program. Families receiving assistance under the solely state-172
funded portion of the temporary family assistance program shall be 173
subject to the same conditions of eligibility as those receiving assistance 174
under the federal temporary assistance for needy families program. 175 Raised Bill No. 5431
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Under the temporary family assistance program, benefits shall be 176
provided to a family for not longer than twenty-one months, except as 177
provided in subsections (b) and (c) of this section. For the purpose of 178
calculating said twenty-one-month time limit, months of assistance 179
received on and after January 1, 1996, pursuant to time limits under the 180
aid to families with dependent children program, shall be included. For 181
purposes of this section, "family" means one or more individuals who 182
apply for or receive assistance together under the temporary family 183
assistance program. If the commissioner determines that federal law 184
allows individuals not otherwise in an eligible covered group for the 185
temporary family assistance program to become covered, such family 186
may also, at the discretion of the commissioner, be composed of (1) a 187
pregnant woman, or (2) a parent, both parents or other caretaker relative 188
and at least one child who is under the age of eighteen, or who is under 189
the age of nineteen and a full-time student in a secondary school or its 190
equivalent. A caretaker relative shall be related to the child or children 191
by blood, marriage or adoption or shall be the legal guardian of such a 192
child or pursuing legal proceedings necessary to achieve guardianship. 193
If the commissioner elects to allow state eligibility consistent with any 194
change in federal law, the commissioner may administratively transfer 195
any qualifying family cases under the cash assistance portion of the 196
state-administered general assistance program to the temporary family 197
assistance program without regard to usual eligibility and enrollment 198
procedures. If such families become an ineligible coverage group under 199
the federal law, the commissioner shall administratively transfer such 200
families back to the cash assistance portion of the state-administered 201
general assistance program without regard to usual eligibility and 202
enrollment procedures to the degree that such families are eligible for 203
the state program. 204
(b) The Commissioner of Social Services shall exempt a family from 205
such time-limited benefits for circumstances including, but not limited 206
to: (1) A family with a needy caretaker relative who is incapacitated or 207
of an advanced age, as defined by the commissioner, if there is no other 208
nonexempt caretaker relative in the household; (2) a family with a needy 209 Raised Bill No. 5431
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caretaker relative who is needed in the home because of the incapacity 210
of another member of the household, if there is no other nonexempt 211
caretaker relative in the household; (3) a family with a caretaker relative 212
who is not legally responsible for the dependent children in the 213
household if such relative's needs are not considered in calculating the 214
amount of the benefit and there is no other nonexempt caretaker relative 215
in the household; (4) a family with a caretaker relative caring for a child 216
who is under one year of age if there is no other nonexempt caretaker 217
relative in the household; (5) a family with a pregnant or postpartum 218
caretaker relative if a physician has indicated that such relative is unable 219
to work and there is no other nonexempt caretaker relative in the 220
household; (6) a family with a caretaker relative determined by the 221
commissioner to be unemployable and there is no other nonexempt 222
caretaker relative in the household; and (7) minor parents attending and 223
satisfactorily completing high school or high school equivalency 224
programs. 225
(c) A family who is subject to time-limited benefits may petition the 226
Commissioner of Social Services for six-month extensions of such 227
benefits. The commissioner shall grant not more than two extensions to 228
such family who has made a good faith effort to comply with the 229
requirements of the program and despite such effort has a total family 230
income at a level below the payment standard, or has encountered 231
circumstances preventing employment including, but not limited to: (1) 232
Domestic violence or physical harm to such family's children; or (2) 233
other circumstances beyond such family's control. The commissioner 234
shall disregard ninety dollars of earned income in determining 235
applicable family income. The commissioner may grant a subsequent 236
six-month extension if each adult in the family meets one or more of the 237
following criteria: (A) The adult is precluded from engaging in 238
employment activities due to domestic violence or another reason 239
beyond the adult's control; (B) the adult has two or more substantiated 240
barriers to employment including, but not limited to, the lack of 241
available child care, substance abuse or addiction, severe mental or 242
physical health problems, one or more severe learning disabilities, 243 Raised Bill No. 5431
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domestic violence or a child who has a serious physical or behavioral 244
health problem; (C) the adult is working thirty-five or more hours per 245
week, is earning at least the minimum wage and continues to earn less 246
than the family's temporary family assistance payment standard; or (D) 247
the adult is employed and works less than thirty-five hours per week 248
due to (i) a documented medical impairment that limits the adult's 249
hours of employment, provided the adult works the maximum number 250
of hours that the medical condition permits, or (ii) the need to care for a 251
disabled member of the adult's household, provided the adult works the 252
maximum number of hours the adult's caregiving responsibilities 253
permit. Families receiving temporary family assistance shall be notified 254
by the department of the right to petition for such extensions. 255
Notwithstanding the provisions of this section, the commissioner shall 256
not provide benefits under the state's temporary family assistance 257
program to a family that is subject to the twenty-one month benefit limit 258
and has received benefits beginning on or after October 1, 1996, if such 259
benefits result in that family's receiving more than sixty months of time-260
limited benefits unless that family experiences domestic violence, as 261
defined in Section 402(a)(7)(B), P.L. 104-193. For the purpose of 262
calculating said sixty-month limit: (I) A month shall count toward the 263
limit if the family receives assistance for any day of the month, provided 264
any months of temporary family assistance received during the public 265
health emergency declared by Governor Ned Lamont related to the 266
COVID-19 pandemic shall not be included, and (II) a month in which a 267
family receives temporary assistance for needy families benefits that are 268
issued from a jurisdiction other than Connecticut shall count toward the 269
limit. 270
(d) Under said program, no family shall be eligible that has total gross 271
earnings exceeding the federal poverty level, however, in the calculation 272
of the benefit amount for eligible families and previously eligible 273
families that become ineligible temporarily because of receipt of 274
workers' compensation benefits by a family member who subsequently 275
returns to work immediately after the period of receipt of such benefits, 276
earned income shall be disregarded up to the federal poverty level. 277 Raised Bill No. 5431
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Except when determining eligibility for a six-month extension of 278
benefits pursuant to subsection (c) of this section, the commissioner 279
shall disregard the first fifty dollars per month of income attributable to 280
current child support that a family receives in determining eligibility 281
and benefit levels for temporary family assistance. Any current child 282
support in excess of fifty dollars per month collected by the department 283
on behalf of an eligible child shall be considered in determining 284
eligibility but shall not be considered when calculating benefits and 285
shall be taken as reimbursement for assistance paid under this section, 286
except that when the current child support collected exceeds the family's 287
monthly award of temporary family assistance benefits plus fifty 288
dollars, the current child support shall be paid to the family and shall be 289
considered when calculating benefits. 290
(e) A family receiving assistance under said program shall cooperate 291
with child support enforcement, under title IV-D of the Social Security 292
Act. A family shall be ineligible for benefits for failure to cooperate with 293
child support enforcement. 294
(f) A family leaving assistance at the end of (1) said twenty-one-295
month time limit, including a family with income above the payment 296
standard, or (2) the sixty-month limit shall have an interview for the 297
purpose of being informed of services that may continue to be available 298
to such family, including employment services available through the 299
Labor Department. Such interview shall include (A) a determination of 300
benefits available to the family provided by the Department of Social 301
Services; and (B) a determination of whether such family is eligible for 302
supplemental nutrition assistance or Medicaid. Information and 303
referrals shall be made to such a family for services and benefits 304
including, but not limited to, the earned income tax credit, rental 305
subsidies emergency housing, employment services and energy 306
assistance. 307
[(g) Notwithstanding section 17b-104, commencing on July 1, 2023, 308
the Commissioner of Social Services shall provide an annual cost-of-309
living adjustment in temporary family assistance benefits equal to the 310 Raised Bill No. 5431
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most recent percentage increase in the consumer price index for urban 311
consumers whenever funds appropriated for temporary family 312
assistance lapse at the close of any fiscal year and such adjustment has 313
not otherwise been included in the budget for the assistance program, 314
provided the increase would not create a budget deficiency in 315
succeeding years. The commissioner shall provide a prorated benefit 316
increase from such available lapsed funds in any fiscal year when such 317
funds are not sufficient to cover a cost-of-living adjustment in 318
accordance with this subsection.] 319
[(h)] (g) An applicant or recipient of temporary family assistance who 320
is adversely affected by a decision of the Commissioner of Social 321
Services may request and shall be provided a hearing in accordance 322
with section 17b-60. 323
Sec. 7. Section 1 of special act 21-1, as amended by section 86 of public 324
act 21-2 of the June special session, is amended to read as follows 325
(Effective from passage): 326
(a) Notwithstanding any provision of the general statutes, not later 327
than [April 26, 2021] June 1, 2022, the Governor shall submit to the 328
speaker of the House of Representatives and the president pro tempore 329
of the Senate recommended allocations of federal funds designated for 330
the state pursuant to the provisions of Subtitle M of Title IX of the 331
American Rescue Plan Act of 2021, P.L. 117-2, as amended from time to 332
time, except for any funds designated under the Coronavirus Local 333
Fiscal Recovery Fund. Not later than five days after receipt of the 334
recommended allocations, the speaker and the president pro tempore 335
shall submit the recommended allocations to the joint standing 336
committee of the General Assembly having cognizance of matters 337
relating to appropriations and the budgets of state agencies. Said 338
committee shall report their approval or modifications, if any, of such 339
recommended allocations to the speaker and the president pro tempore 340
not later than [May 16, 2021] July 1, 2022. Any partial or final allocations 341
of such funds shall be authorized by public or special act of the General 342
Assembly. Disbursement of such funds shall be in accordance with such 343 Raised Bill No. 5431
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partial or final allocations and no disbursement of such funds shall 344
occur prior to such authorization. 345
(b) If it is determined that any amount allocated by the General 346
Assembly pursuant to subsection (a) of this section is not allowable 347
under guidance provided by the federal government, including, but not 348
limited to, the United States Treasury, the Secretary of the Office of 349
Policy and Management shall immediately notify the joint standing 350
committee of the General Assembly having cognizance of matters 351
relating to appropriations and the budgets of state agencies of the 352
specific amount and recipient of such allocation and the reason for such 353
determination. 354
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
Sec. 7 from passage SA 21-1, Sec. 1
Statement of Purpose:
To make changes concerning the expenditure of funds received by the
state under the Federal American Rescue Plan Act of 2021.
[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.]