Substitute Senate Bill No. 286
Public Act No. 22-145
AN ACT CONCERNING ELDER ABUSE REPORTING DEADLINES,
TEMPORARY FAMILY ASSISTANCE, CERTIFICATES OF NEED
FOR LONG-TERM CARE FACILITIES AND CIVIL PENALTIES FOR
NURSING HOMES THAT FAIL TO USE RATE INCREASES FOR
EMPLOYEE WAGE ENHANCEMENTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (a) of section 17b-451 of the 2022 supplement to
the general statutes is repealed and the following is substituted in lieu
thereof (Effective July 1, 2022):
(a) A mandatory reporter who has reasonable cause to suspect or
believe that any elderly person has been abused, neglected, exploited or
abandoned, or is in a condition that is the result of such abuse, neglect,
exploitation or abandonment, or is in need of protective services, shall,
not later than [seventy-two] twenty-four hours after such suspicion or
belief arose, report such information or cause a report to be made in any
reasonable manner to the Commissioner of Social Services or to the
person or persons designated by the commissioner to receive such
reports. Any mandatory reporter who fails for the first time to make
such report within the prescribed time shall [be fined not more than five
hundred dollars, except that, if] retake the mandatory training on
detecting potential abuse, neglect, exploitation and abandonment of Substitute Senate Bill No. 286
Public Act No. 22-145 2 of 19
elderly persons and provide the commissioner with proof of successful
completion of such training. Any mandatory reporter who subsequently
fails to make such report within the prescribed time period shall be fined
not more than five hundred dollars and shall retake the mandatory
training on detecting potential abuse, neglect, exploitation and
abandonment of elderly persons and provide the commissioner with
proof of successful completion of such training. If such person
intentionally fails to make such report within the prescribed time
period, such person shall be guilty of a class C misdemeanor for the first
offense and a class A misdemeanor for any subsequent offense. Any
institution, organization, agency or facility employing individuals to
care for persons sixty years of age or older shall provide mandatory
training on detecting potential abuse, neglect, exploitation and
abandonment of such persons and inform such employees of their
obligations under this section. For purposes of this subsection,
"mandatory reporter" means any (1) physician or surgeon licensed
under the provisions of chapter 370, (2) resident physician or intern in
any hospital in this state, whether or not so licensed, (3) registered nurse,
(4) nursing home administrator, nurse's aide or orderly in a nursing
home facility or residential care home, (5) person paid for caring for a
resident in a nursing home facility or residential care home, (6) staff
person employed by a nursing home facility or residential care home,
(7) residents' advocate, other than a representative of the Office of the
Long-Term Care Ombudsman, as established under section 17a-405,
including the State Ombudsman, (8) licensed practical nurse, medical
examiner, dentist, optometrist, chiropractor, podiatrist, social worker,
clergyman, police officer, pharmacist, psychologist or physical
therapist, (9) person paid for caring for an elderly person by any
institution, organization, agency or facility, including but not limited to,
any employee of a community-based services provider, senior center,
home care agency, homemaker and companion agency, adult day care
center, village-model community and congregate housing facility, (10)
person licensed or certified as an emergency medical services provider Substitute Senate Bill No. 286
Public Act No. 22-145 3 of 19
pursuant to chapter 368d or 384d, including any such emergency
medical services provider who is a member of a municipal fire
department, and (11) driver of a paratransit vehicle, as defined in section
13b-38k.
Sec. 2. Subsection (b) of section 17b-688c of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2022):
(b) In no event shall temporary family assistance be granted to an
applicant for such assistance, who is not exempt from participation in
the employment services program, prior to the applicant's attendance at
an initial scheduled employment services assessment interview and
participation in the development of an employment services plan. The
Department of Social Services shall [not delay temporary family
assistance to an applicant in cases where the department schedules]
promptly conduct an application interview with an applicant for
temporary family assistance to determine whether such applicant is
exempt from participation in the employment services program. If the
department determines that such applicant is not exempt, the
department shall schedule the initial employment services assessment
interview not later than ten business days after the date of the
application interview. In cases where the department does not schedule
the initial employment services assessment interview [more than]
within ten business days [after] of the date on which the application [for
assistance is made, or in cases where] interview was completed, or
where the Labor Department does not complete an employment
services plan for the benefit of the applicant within ten business days of
the date on which the applicant attends an employment services
assessment interview, the Department of Social Services shall not delay
granting temporary family assistance to an applicant who is otherwise
eligible for such assistance. The Commissioner of Social Services shall
refer any applicant denied temporary family assistance, who may be in Substitute Senate Bill No. 286
Public Act No. 22-145 4 of 19
need of emergency benefits, to other services offered by the Department
of Social Services or community services that may be available to such
applicant. The Department of Social Services shall reduce the benefits
awarded to a family under the temporary family assistance program
when a member of the family who is required to participate in the
employment services program fails to comply with an employment
services requirement without good cause. [The first instance of
noncompliance with an employment services requirement shall result
in a twenty-five per cent reduction of such benefits for three consecutive
months. The second instance of noncompliance with such requirement
shall result in a thirty-five per cent reduction of such benefits for three
consecutive months. A third or subsequent instance of noncompliance
with such requirement shall result in the termination of such benefits
for three consecutive months.] The Department of Social Services shall
impose this reduction by excluding the noncompliant family member
from the household when calculating the family's monthly benefit. Such
exclusion shall continue until the noncompliant family member (1)
begins to comply with employment services requirements, (2) becomes
exempt from such requirements, or (3) demonstrates good cause for his
or her failure to comply with such requirements. If only one member of
a family is eligible for temporary family assistance and such member
fails without good cause to comply with an employment services
requirement, the department shall [terminate all benefits of such family
for three consecutive months Notwithstanding the provisions of this
subsection, the department shall terminate the benefits awarded to a
family under the temporary family assistance program if a member of
the family who is not exempt from the twenty-one-month time limit
specified in subsection (a) of section 17b-112 fails, without good cause,
to: (1) Attend any scheduled assessment appointment or interview
relating to the establishment of an employment services plan, except
that such individual's benefits shall be reinstated if the individual
attends a subsequently scheduled appointment or interview within
thirty days of the date on which the department has issued notification Substitute Senate Bill No. 286
Public Act No. 22-145 5 of 19
to the individual that benefits have been terminated, or (2) comply with
an employment services requirement during a six-month extension of
benefits. Any individual who fails to comply with the provisions of
subdivision (1) of this subsection may submit a new application for such
benefits at any time after termination of benefits] reduce such family's
benefit by twenty-five per cent for each month such member fails to
comply.
Sec. 3. Section 1-24 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective from passage):
The following officers may administer oaths: (1) The clerks of the
Senate, the clerks of the House of Representatives and the chairpersons
of committees of the General Assembly or of either branch thereof,
during its session; (2) state officers, as defined in subsection (t) of section
9-1, judges and clerks of any court, family support magistrates, judge
trial referees, justices of the peace, commissioners of the Superior Court,
notaries public, town clerks and assistant town clerks, in all cases where
an oath may be administered, except in a case where the law otherwise
requires; (3) commissioners on insolvent estates, auditors, arbitrators
and committees, to parties and witnesses, in all cases tried before them;
(4) assessors and boards of assessment appeals, in cases coming before
them; (5) commissioners appointed by governors of other states to take
the acknowledgment of deeds, in the discharge of their official duty; (6)
the moderator of a school district meeting, in such meeting, to the clerk
of such district, as required by law; (7) the chief elected official of a
municipality, in any matter before the chief elected official of a
municipality; (8) the Chief Medical Examiner, Deputy Medical
Examiner and assistant medical examiners of the Office of the Medical
Examiner, in any matter before them; (9) registrars of vital statistics, in
any matter before them; (10) any chief inspector or inspector appointed
pursuant to section 51-286; (11) registrars of voters, deputy registrars,
assistant registrars, and moderators, in any matter before them; (12) Substitute Senate Bill No. 286
Public Act No. 22-145 6 of 19
special assistant registrars, in matters provided for in subsections (b)
and (c) of section 9-19b and section 9-19c; (13) the Commissioner of
Emergency Services and Public Protection and any sworn member of
any local police department or the Division of State Police within the
Department of Emergency Services and Public Protection, in all
affidavits, statements, depositions, complaints or reports made to or by
any member of any local police department or said Division of State
Police or any constable who is under the supervision of said
commissioner or any of such officers of said Division of State Police and
who is certified under the provisions of sections 7-294a to 7-294e,
inclusive, and performs criminal law enforcement duties; (14) judge
advocates of the United States Army, Navy, Air Force and Marine
Corps, law specialists of the United States Coast Guard, adjutants,
assistant adjutants, acting adjutants and personnel adjutants,
commanding officers, executive officers and officers whose rank is
lieutenant commander or major, or above, of the armed forces, as
defined in section 27-103, to persons serving with or in the armed forces,
as defined in said section, or their spouses; (15) investigators, deputy
investigators, investigative aides, secretaries, clerical assistants, social
workers, social worker trainees, paralegals and certified legal interns
employed by or assigned to the Public Defender Services Commission
in the performance of their assigned duties; (16) bail commissioners,
intake, assessment and referral specialists, family relations counselors,
support enforcement officers, chief probation officers and supervisory
judicial marshals employed by the Judicial Department in the
performance of their assigned duties; (17) juvenile matter investigators
employed by the Division of Criminal Justice in the performance of their
assigned duties; (18) the chairperson of the Connecticut Siting Council
or the chairperson's designee; (19) the presiding officer at an agency
hearing under section 4-177b; (20) investigators employed by the
Department of Social Services Office of Child Support Services, in the
performance of their assigned duties; (21) the chairperson, vice-
chairperson, members and employees of the Board of Pardons and Substitute Senate Bill No. 286
Public Act No. 22-145 7 of 19
Paroles, in the performance of their assigned duties; (22) the
Commissioner of Correction or the commissioner's designee; (23) sworn
law enforcement officers, appointed under section 26-5, within the
Department of Energy and Environmental Protection, in all affidavits,
statements, depositions, complaints or reports made to or by any such
sworn law enforcement officer; [and] (24) sworn motor vehicle
inspectors acting under the authority of section 14-8; and (25) eligibility
workers, specialists and supervisors employed by the Department of
Social Services for the sole purpose of witnessing the execution of an
affirmation or acknowledgment of parentage when their assigned
duties include witnessing such execution.
Sec. 4. Subsection (b) of section 46b-171 of the 2022 supplement to the
general statutes is repealed and the following is substituted in lieu
thereof (Effective July 1, 2022):
(b) (1) Except as provided in subdivision (2) of this subsection, a
judgment of parentage entered by the Superior Court or family support
magistrate pursuant to this chapter may not be opened or set aside
unless (A) a motion to open or set aside is filed not later than four
months after the date on which the judgment was entered, and (B) upon
a showing (i) of reasonable cause, or (ii) that a valid defense to the
petition for a judgment of parentage existed, in whole or in part, at the
time judgment was rendered, and the person seeking to open or set
aside the judgment was prevented by mistake, accident or other
reasonable cause from making a valid defense.
(2) The Superior Court or a family support magistrate may consider
a motion to open or set aside a judgment of parentage filed more than
four months after such judgment was entered if such court or magistrate
determines that the judgment was entered due to fraud, duress or
material mistake of fact. The burden of proof shall be on the person
seeking to open or set aside such judgment. If the court or family
support magistrate determines such person has met the burden of proof Substitute Senate Bill No. 286
Public Act No. 22-145 8 of 19
under this subdivision, the judgment shall be set aside only if the court
or family support magistrate determines that doing so is in the best
interest of the child, based on the relevant factors set forth in section 46b-
475.
[(b)] (3) Whenever the Superior Court or family support magistrate
[reopens] opens a judgment of parentage entered pursuant to this
section in which a person was found to be the parent of a child who is
or has been supported by the state and the court or family support
magistrate finds that the person adjudicated the parent is not the parent
of the child, the Department of Social Services shall refund to such
person any money paid to the state by such person during the period
such child was supported by the state.
Sec. 5. (NEW) (Effective from passage) (a) In addition to any applicable
recoupment or rate decrease pursuant to any other provision of the
general statutes, a nursing home facility that receives a rate increase for
wage enhancements for facility employees may also be assessed a civil
penalty if the facility fails to use the rate increase for that purpose. The
Department of Social Services may assess a civil penalty upon
completion of a department audit conducted in accordance with the
nursing home facility's Medicaid provider enrollment agreements. The
civil penalty assessed pursuant to this section shall not exceed an
amount greater than fifty per cent of the total dollar amount of the rate
increase received by the nursing home facility but not used for wage
enhancements for facility employees.
(b) The department, in its sole discretion, may enter into a
recoupment schedule with a nursing home facility so as not to
negatively impact patient care. Any nursing home facility subject to a
civil penalty assessed in accordance with this section may request a
rehearing pursuant to subsection (b) of section 17b-238 of the general
statutes. The provisions of this section shall apply to all rate increases
for wage enhancements received by nursing home facilities pursuant to Substitute Senate Bill No. 286
Public Act No. 22-145 9 of 19
the provisions of section 323 of public act 21-2 of the June special session
prior to the effective date of this section.
Sec. 6. Section 17b-352 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2022):
(a) For the purposes of this section and section 17b-353, as amended
by this act, "facility" means a residential facility for persons with
intellectual disability licensed pursuant to section 17a-277 and certified
to participate in the Title XIX Medicaid program as an intermediate care
facility for individuals with intellectual disabilities, a nursing home, rest
home or residential care home, as defined in section 19a-490. "Facility"
does not include a nursing home that does not participate in the
Medicaid program and is associated with a continuing care facility as
described in section 17b-520.
(b) Any facility which intends to (1) transfer all or part of its
ownership or control prior to being initially licensed; (2) introduce any
additional function or service into its program of care or expand an
existing function or service; (3) terminate a service or decrease
substantially its total licensed bed capacity; or (4) relocate all or a portion
of such facility's licensed beds, to a new facility or replacement facility,
shall submit a complete request for permission to implement such
transfer, addition, expansion, increase, termination, decrease or
relocation of facility beds to the Department of Social Services with such
information as the department requires, provided no permission or
request for permission to close a facility is required when a facility in
receivership is closed by order of the Superior Court pursuant to section
19a-545. The Commissioner of Social Services shall consider the criteria
in subdivisions (3) and (4) of subsection (a) of section 17b-354, as
amended by this act, when evaluating a certificate of need request to
relocate licensed nursing facility beds from an existing facility to another
licensed nursing facility or to a new facility or replacement facility. The
Office of the Long-Term Care Ombudsman pursuant to section 17a-405 Substitute Senate Bill No. 286
Public Act No. 22-145 10 of 19
shall be notified by the facility of any proposed actions pursuant to this
subsection at the same time the request for permission is submitted to
the department and when a facility in receivership is closed by order of
the Superior Court pursuant to section 19a-545.
(c) A facility may submit a petition for closure to the Department of
Social Services. The Department of Social Services may authorize the
closure of a facility if the facility's management demonstrates to the
satisfaction of the Commissioner of Social Services in the petition for
closure that the facility (1) is not viable based on actual and projected
operating losses; (2) has an occupancy rate of less than seventy per cent
of the facility's licensed bed capacity; (3) closure is consistent with the
strategic rebalancing plan developed in accordance with section 17b-
369, including bed need by geographical region; (4) is in compliance
with the requirements of Sections 1128I(h) and 1819(h)(4) of the Social
Security Act and 42 CFR 483.75; and (5) is not providing special services
that would go unmet if the facility closes. The department shall review
a petition for closure to the extent it deems necessary and the facility
shall submit information the department requests or deems necessary
to substantiate that the facility closure is consistent with the provisions
of this subsection. The facility shall submit information the department
requests or deems necessary to allow the department to provide
oversight during this process. The Office of the Long-Term Care
Ombudsman shall be notified by the facility at the same time as a
petition for closure is submitted to the department. Any facility acting
pursuant to this subsection shall provide written notice, on the same
date that the facility submits its petition for closure, to all patients,
guardians or conservators, if any, or legally liable relatives or other
responsible parties, if known, and shall post such notice in a
conspicuous location at the facility. The facility's written notice shall be
accompanied by an informational letter issued jointly from the Office of
the Long-Term Care Ombudsman and the Department of Rehabilitation
Services on patients' rights and services available as they relate to the Substitute Senate Bill No. 286
Public Act No. 22-145 11 of 19
petition for closure. The informational letter shall also state the date and
time that the Office of the Long-Term Care Ombudsman and the
Department of Public Health will hold an informational session at the
facility for patients, guardians or conservators, if any, and legally liable
relatives or other responsible parties, if known, about their rights and
the process concerning a petition for closure. The notice shall state: (A)
The date the facility submitted the petition for closure, (B) that only the
Department of Social Services has the authority to either grant or deny
the petition for closure, (C) that the Department of Social Services has
up to thirty days to grant or deny the petition for closure, (D) a brief
description of the reason or reasons for submitting the petition for
closure, (E) that no patient shall be involuntarily transferred or
discharged within or from a facility pursuant to state and federal law
because of the filing of a petition for closure, (F) that all patients have a
right to appeal any proposed transfer or discharge, and (G) the name,
mailing address and telephone number of the Office of the Long-Term
Care Ombudsman and local legal aid office. The commissioner shall
grant or deny a petition for closure within thirty days of receiving such
request.
(d) An applicant, prior to submitting a certificate of need application,
shall request, in writing, application forms and instructions from the
department. The request shall include: (1) The name of the applicant or
applicants; (2) a statement indicating whether the application is for (A)
a new, additional, expanded or replacement facility, service or function
or relocation of facility beds, (B) a termination or reduction in a
presently authorized service or bed capacity, or (C) any new, additional
or terminated beds and their type; (3) the estimated capital cost; (4) the
town where the project is or will be located; and (5) a brief description
of the proposed project. Such request shall be deemed a letter of intent.
No certificate of need application shall be considered submitted to the
department unless a current letter of intent, specific to the proposal and
in accordance with the provisions of this subsection, has been on file Substitute Senate Bill No. 286
Public Act No. 22-145 12 of 19
with the department for not less than ten business days. For purposes of
this subsection, "a current letter of intent" means a letter of intent on file
with the department for not more than one hundred eighty days. A
certificate of need application shall be deemed withdrawn by the
department, if a department completeness letter is not responded to
within one hundred eighty days. The Office of the Long-Term Care
Ombudsman shall be notified by the facility at the same time as the letter
of intent is submitted to the department.
(e) Any facility acting pursuant to subdivision (3) of subsection (b) of
this section shall provide written notice, at the same time it submits its
letter of intent, to all patients, guardians or conservators, if any, or
legally liable relatives or other responsible parties, if known, and shall
post such notice in a conspicuous location at the facility. The facility's
written notice shall be accompanied by an informational letter issued
jointly from the Office of the Long-Term Care Ombudsman and the
Department of Aging and Disability Services on patients' rights and
services available as they relate to the letter of intent. The notice shall
state the following: (1) The projected date the facility will be submitting
its certificate of need application, (2) that only the Department of Social
Services has the authority to either grant, modify or deny the
application, (3) that the Department of Social Services has up to ninety
days to grant, modify or deny the certificate of need application, (4) a
brief description of the reason or reasons for submitting a request for
permission, (5) that no patient shall be involuntarily transferred or
discharged within or from a facility pursuant to state and federal law
because of the filing of the certificate of need application, (6) that all
patients have a right to appeal any proposed transfer or discharge, and
(7) the name, mailing address and telephone number of the Office of the
Long-Term Care Ombudsman and local legal aid office.
(f) The [department] Department of Social Services shall review a
request made pursuant to subsection (b) of this section to the extent it Substitute Senate Bill No. 286
Public Act No. 22-145 13 of 19
deems necessary, including, but not limited to, in the case of a proposed
transfer of ownership or control prior to initial licensure, the financial
responsibility and business interests of the transferee and the ability of
the facility to continue to provide needed services, or in the case of the
addition or expansion of a function or service, ascertaining the
availability of the function or service at other facilities within the area to
be served, the need for the service or function within the area and any
other factors the department deems relevant to a determination of
whether the facility is justified in adding or expanding the function or
service. During the review, the department may hold an informal
conference with the facility to discuss the certificate of need application.
The [commissioner] Commissioner of Social Services shall grant, modify
or deny the request within ninety days of receipt thereof, except as
otherwise provided in this section. The commissioner may place
conditions, as the commissioner deems necessary to address specified
concerns, on any decision approving or modifying a request for a
certificate of need filed pursuant to this section. Conditions may include,
but are not limited to, project and Medicaid reimbursement details and
applicant requirements for summary and audit purposes. If the
commissioner modifies the request, the commissioner shall notify the
facility of such modification prior to issuing the decision and provide
the applicant with an opportunity for an informal conference to discuss
the modifications. Upon the request of the applicant, the review period
may be extended for an additional fifteen days if the department has
requested additional information subsequent to the commencement of
the commissioner's review period. The director of the office of certificate
of need and rate setting may extend the review period for a maximum
of thirty days if the applicant has not filed in a timely manner
information deemed necessary by the department. The applicant may
request and shall receive a hearing in accordance with section 4-177 if
aggrieved by a decision of the commissioner.
(g) The Commissioner of Social Services shall not approve any Substitute Senate Bill No. 286
Public Act No. 22-145 14 of 19
requests for beds in residential facilities for persons with intellectual
disability which are licensed pursuant to section 17a-227 and are
certified to participate in the Title XIX Medicaid Program as
intermediate care facilities for individuals with intellectual disabilities,
except those beds necessary to implement the residential placement
goals of the Department of Developmental Services which are within
available appropriations.
(h) The Commissioner of Social Services shall adopt regulations, in
accordance with chapter 54, to implement the provisions of this section.
Sec. 7. Subsections (c) and (d) of section 17b-353 of the general statutes
are repealed and the following is substituted in lieu thereof (Effective July
1, 2022):
(c) In conducting its activities pursuant to this section, section 17b-
352, as amended by this act, or both, except as provided for in subsection
(d) of this section, the Commissioner of Social Services or said
commissioner's designee may hold a public hearing on an application
or on more than one application, if such applications are of a similar
nature with respect to the request. At least two weeks' notice of the
hearing shall be given to the facility by certified mail and to the public
by publication in a newspaper having a substantial circulation in the
area served by the facility. Such hearing shall be held at the discretion
of the commissioner in Hartford or in the area so served. Prior to the
hearing, the department may hold an informal conference with the
facility to discuss the certificate of need application. The commissioner
or the commissioner's designee shall consider such request in relation to
the community or regional need for such capital program or purchase
of land, the possible effect on the operating costs of the facility and such
other relevant factors as the commissioner or the commissioner's
designee deems necessary. In approving or modifying such request, the
commissioner or the commissioner's designee may not prescribe any
condition, such as, but not limited to, any condition or limitation on the Substitute Senate Bill No. 286
Public Act No. 22-145 15 of 19
indebtedness of the facility in connection with a bond issued, the
principal amount of any bond issued or any other details or particulars
related to the financing of such capital expenditure, not directly related
to the scope of such capital program and within the control of the
facility. If the hearing is conducted by a designee of the commissioner,
the designee shall submit any findings and recommendations to the
commissioner. If the designee recommends denial of the request, the
designee shall issue a proposed final decision in accordance with section
4-179. The commissioner shall grant, modify or deny such request
within ninety days, except as provided for in this section. The
commissioner may place conditions, as the commissioner deems
necessary to address specified concerns, on any decision approving or
modifying a request for a certificate of need filed pursuant to this
section. Conditions may include, but are not limited to, project and
Medicaid reimbursement details and applicant requirements for
summary and audit purposes. Upon the request of the applicant, the
review period may be extended for an additional fifteen days if the
commissioner or the commissioner's designee has requested additional
information subsequent to the commencement of the review period. The
commissioner or the commissioner's designee may extend the review
period for a maximum of thirty days if the applicant has not filed in a
timely manner information deemed necessary by the commissioner or
the commissioner's designee.
(d) Except as provided in this subsection, no facility shall be allowed
to close or decrease substantially its licensed total bed capacity until
such time as a public hearing has been held in accordance with the
provisions of this subsection and the Commissioner of Social Services
has approved the facility's request unless such decrease is associated
with a census reduction. The commissioner may impose a civil penalty
of not more than five thousand dollars on any facility that fails to
comply with the provisions of this subsection. Penalty payments
received by the commissioner pursuant to this subsection shall be Substitute Senate Bill No. 286
Public Act No. 22-145 16 of 19
deposited in the special fund established by the department pursuant to
subsection (c) of section 17b-357 and used for the purposes specified in
said subsection (c). The commissioner or the commissioner's designee
shall hold a public hearing [upon the earliest occurrence of: (1) Receipt
of any letter of intent submitted by a facility to the department, or (2)]
not later than thirty days after the receipt of any certificate of need
application. Such hearing shall be held at the facility for which the [letter
of intent or] certificate of need application was submitted. [not later than
thirty days after the date on which such letter or application was
received by the commissioner.] The commissioner or the
commissioner's designee shall provide both the facility and the public
with notice of the date of the hearing not less than [fourteen] ten days in
advance of such date. Notice to the facility shall be [by certified mail]
sent via electronic mail or first-class mail and notice to the public shall
be by publication in a newspaper having a substantial circulation in the
area served by the facility. The provisions of this subsection shall not
apply to any certificate of need approval requested for the relocation of
a facility, or a portion of a facility's licensed beds, to a new or
replacement facility.
Sec. 8. Subsection (a) of section 17b-354 of the general statutes is
repealed and the following is substituted in lieu thereof (Effective July 1,
2022):
(a) The Department of Social Services shall not accept or approve any
requests for additional nursing home beds, except (1) beds restricted to
use by patients with acquired immune deficiency syndrome or by
patients requiring neurological rehabilitation; (2) beds associated with a
continuing care facility, as described in section 17b-520, provided such
beds are not used in the Medicaid program. [and the ratio of proposed
nursing home beds to the continuing care facility's independent living
units is within applicable industry standards.] For the purpose of this
subsection, beds associated with a continuing care facility are not subject Substitute Senate Bill No. 286
Public Act No. 22-145 17 of 19
to the certificate of need provisions pursuant to sections 17b-352, as
amended by this act, and 17b-353, as amended by this act; (3) Medicaid
certified beds to be relocated from one licensed nursing facility to
another licensed nursing facility to meet a priority need identified in the
strategic plan developed pursuant to subsection (c) of section 17b-369;
[and] (4) licensed Medicaid nursing facility beds to be relocated from
one or more existing nursing facilities to a new nursing facility,
including a replacement facility, provided (A) no new Medicaid
certified beds are added, (B) at least one currently licensed facility is
closed in the transaction as a result of the relocation, (C) the relocation
is done within available appropriations, (D) the facility participates in
the Money Follows the Person demonstration project pursuant to
section 17b-369, (E) the availability of beds in the area of need will not
be adversely affected, (F) the certificate of need approval for such new
facility or facility relocation and the associated capital expenditures are
obtained pursuant to sections 17b-352, as amended by this act, and 17b-
353, as amended by this act, and (G) the facilities included in the bed
relocation and closure shall be in accordance with the strategic plan
developed pursuant to subsection (c) of section 17b-369; and (5)
proposals to build a nontraditional, small-house style nursing home
designed to enhance the quality of life for nursing facility residents,
provided that the nursing facility agrees to reduce its total number of
licensed beds by a percentage determined by the Commissioner of
Social Services in accordance with the department's strategic plan for
long-term care.
Sec. 9. Section 17b-355 of the general statutes is repealed and the
following is substituted in lieu thereof (Effective July 1, 2022):
In determining whether a request submitted pursuant to sections
17b-352 to 17b-354, inclusive, as amended by this act, will be granted,
modified or denied, the Commissioner of Social Services shall consider
the following: The [relationship of the request to the state health plan, Substitute Senate Bill No. 286
Public Act No. 22-145 18 of 19
the] financial feasibility of the request and its impact on the applicant's
rates and financial condition, the contribution of the request to the
quality, accessibility and cost-effectiveness of [health care delivery] the
delivery of long-term care in the region, whether there is clear public
need for the request, the relationship of any proposed change to the
applicant's current utilization statistics and the effect of the proposal on
the utilization statistics of other facilities in the applicant's service area,
the business interests of all owners, partners, associates, incorporators,
directors, sponsors, stockholders and operators and the personal
background of such persons, and any other factor which the
[department] Department of Social Services deems relevant. [Whenever
the granting, modification or denial of a request is inconsistent with the
state health plan, a written explanation of the reasons for the
inconsistency shall be included in the decision. In considering whether
there is clear public need for any request for additional nursing home
beds associated with a continuing care facility submitted pursuant to
section 17b-354, the commissioner shall only consider the need for beds
for current and prospective residents of the continuing care facility.] In
considering whether there is clear public need for any request for the
relocation of beds to a replacement facility, the commissioner shall
consider whether there is a demonstrated bed need in the towns within
a fifteen-mile radius of the town in which the beds are proposed to be
located and whether the availability of beds in the applicant's service
area will be adversely affected. Any proposal to relocate nursing home
beds from an existing facility to a new facility shall not increase the
number of Medicaid certified beds and shall result in the closure of at
least one currently licensed facility. The commissioner may request that
any applicant seeking to replace an existing facility reduce the number
of beds in the new facility by a percentage that is consistent with the
department's strategic plan for long-term care. If an applicant seeking to
replace an existing facility with a new facility owns or operates more
than one nursing facility, the commissioner may request that the
applicant close two or more facilities before approving the proposal to Substitute Senate Bill No. 286
Public Act No. 22-145 19 of 19
build a new facility. The commissioner shall also consider whether an
application to establish a new or replacement nursing facility proposes
a nontraditional, small-house style nursing facility and incorporates
goals for nursing facilities referenced in the department's strategic plan
for long-term care, including, but not limited to, (1) promoting person-
centered care, (2) providing enhanced quality of care, (3) creating
community space for all nursing facility residents, and (4) developing
stronger connections between the nursing facility residents and the
surrounding community. Bed need shall be based on the recent
occupancy percentage of area nursing facilities and the projected bed
need for no more than five years into the future at ninety-seven and one-
half per cent occupancy using the latest official population projections
by town and age as published by the Office of Policy and Management
and the latest available state-wide nursing facility utilization statistics
by age cohort from the Department of Public Health. The commissioner
may also consider area specific utilization and reductions in utilization
rates to account for the increased use of less institutional alternatives.