Researcher: JP Page 1 5/4/22
OLR Bill Analysis
sSB 286 (File 183, as amended by Senate "A")*
AN ACT CONCERNING DEADLINES FOR MANDATORY
REPORTING OF SUSPECTED ELDER ABUSE AND PENALTIES
FOR FAILURE TO REPORT.
TABLE OF CONTENTS:
§ 1 ― SHORTENED REPORTING DEADLINE FOR SUSPECTED ELDER
ABUSE
Reduces, from 72 hours to 24 hours, mandated reporting timeframes for elderly protective
services, adds a training requirement for violators, and eliminates related fines for first-
time offenses
§ 501 ― TFA EMPLOYMENT REQUIREMENTS
Makes various changes to timelines and penalties for TFA’s employment services program
§ 502 ― DSS ELIGIBILITY WORKERS TO ADMINISTER OATHS
Allows DSS’s eligibility workers, specialists, and supervisors to administer oaths when
their assigned duties require witnessing the execution of an affirmation or
acknowledgment of parentage
§ 503 ― OPENING OR SETTING ASIDE OF A PARENTAGE
JUDGMENT
Establishes the circumstances under which the Superior Court or family support
magistrate may open or set aside a judgement of parentage
§ 504 ― PENALTIES FOR UNAUTHORIZED USE OF RATE
INCREASES EARMARKED FOR NURSING HOME STAFF WAGE
ENHANCEMENTS
Allows DSS to assess a civil penalty on a nursing home that receives a rate increase to
enhance its employees’ wages but fails to use it for that purpose
§§ 505-508 ― CERTIFICATES OF NEED FOR LONG -TERM CARE
FACILITIES
Makes various changes to the DSS certificate of need (CON) process for certain long-term
care facilities, including allowing DSS to approve requests to build nontraditional, small-
house style nursing homes under certain conditions
*Senate Amendment “A” adds the provisions on (1) Temporary
Family Assistance (TFA) employment requirements, (2) DSS eligibility
workers administering oaths, (3) the opening or setting aside of a 2022SB-00286-R01-BA.DOCX
Researcher: JP Page 2 5/4/22
parentage judgment, (4) penalties for unauthorized use of nursing home
staff wage increases, and (5) certificates of need for long-term care
facilities.
§ 1 ― SHORTENED REPORTING DEADLINE FOR SUSPE CTED
ELDER ABUSE
Reduces, from 72 hours to 24 hours, mandated reporting timeframes for elderly protective
services, adds a training requirement for violators, and eliminates related fines for first-
time offenses
The bill reduces, from 72 hours to 24 hours, mandated reporting
timeframes for elderly protective services.
Under current law, mandated reporters who fail to timely report to
the Department of Social Services (DSS) when they have reasonable
cause to suspect that an elderly person needs protective services or has
been abused, neglected, exploited, or abandoned, are subject to a fine of
up to $500. The bill eliminates the fine for a first-time failure and instead
requires someone who fails to report within the required 24-hour
timeframe for the first time to retake the mandatory elder abuse training
and provide the DSS commissioner with proof of successful training
completion. It requires repeat violators to (1) retake the training and
provide the proof of successful training completion and (2) be fined up
to $500.
Under existing law, unchanged by the bill, intentional failure to
report is a class C misdemeanor for the first offense, punishable by up
to three months in prison, a fine of up to $500, or both. Subsequent
offenses are a class A misdemeanor, punishable by up to 364 days in
prison, a fine of up to $2,000, or both.
EFFECTIVE DATE: July 1, 2022
§ 501 ― TFA EMPLOYMENT REQUIREMENTS
Makes various changes to timelines and penalties for TFA’s employment services program
By law, Temporary Family Assistance (TFA) applicants who are
subject to work requirements through the employment services
program must attend an assessment interview with the Department of
Labor (DOL) and participate in developing an employment plan before 2022SB-00286-R01-BA.DOCX
Researcher: JP Page 3 5/4/22
the Department of Social Services (DSS) may grant them cash assistance
under TFA. The bill starts the 10-day time frame for DSS to schedule an
assessment interview on the day DSS completes an application
interview, rather than on the day the application is made. It also changes
the way DSS calculates penalties for a TFA participant’s failure to
comply with work requirements.
The bill also eliminates provisions under current law requiring DSS
to terminate TFA benefits awarded to a family under certain
circumstances. Specifically, the department must terminate these
benefits when a family member who is not exempt from the program’s
21-month time limit fails, without good cause, to do either of the
following:
1. attend any scheduled assessment appointment or interview
related to establishing an employment services plan, unless he or
she attends a subsequently scheduled appointment or interview
within 30 days after receiving DSS’s notice that benefits are
terminated, or
2. comply with a work requirement during a six-month extension
of benefits.
EFFECTIVE DATE: July 1, 2022
Application Process and Interviews
The bill requires DSS to promptly conduct an application interview
with a TFA applicant to determine whether he or she is exempt from
work requirements under DOL’s employment services program. Under
the bill, if DSS determines the applicant is not exempt, the department
must schedule the initial employment services interview with DOL
within 10 business days after the application interview. If DSS fails to
do so within that timeframe, the bill prohibits DSS from delaying TFA
benefits to an applicant who is otherwise eligible.
Additionally, the bill eliminates a provision prohibiting DSS from
delaying TFA benefits to an applicant when the department schedules
the initial employment services assessment interview more than 10 2022SB-00286-R01-BA.DOCX
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business days after the applicant submits the application.
Existing law also prohibits DSS from delaying benefits when DOL
does not complete the applicant’s employment services plan within 10
business days after the applicant’s employment services assessment
interview.
Penalty Calculations
Under current law, DSS must reduce TFA benefits awarded to a
family when a family member fails to comply with a work requirement
without good cause, as follows:
1. for the first instance, a 25% reduction in benefits for three
consecutive months;
2. for the second instance, a 35% reduction in benefits for three
consecutive months; and
3. for third and subsequent instances, termination of benefits for
three consecutive months.
The bill instead requires DSS to reduce benefits for failure to comply
with work requirements by excluding the noncompliant family member
from the household when calculating the family’s monthly benefit. (TFA
benefits are based, in part, on household size. Generally, reducing the
number of people in the household reduces the household’s benefit
amount.) Under the bill, DSS must exclude the noncompliant family
member until he or she (1) begins to comply with work requirements,
(2) becomes exempt from work requirements, or (3) demonstrates good
cause for failing to comply.
If only one family member is eligible for TFA and he or she fails to
comply with a work requirement, current law requires DSS to terminate
the family’s benefits for three consecutive months. Under the bill, DSS
must instead reduce the family’s benefit by 25% for each month the
person fails to comply, and only if the failure to comply is without good
cause. 2022SB-00286-R01-BA.DOCX
Researcher: JP Page 5 5/4/22
Background ― Related Bill
SB 192 (File 215), favorably reported by the Human Services
Committee, has identical provisions regarding TFA employment
requirements.
§ 502 ― DSS ELIGIBILITY WORKERS TO ADMINISTER OATHS
Allows DSS’s eligibility workers, specialists, and supervisors to administer oaths when
their assigned duties require witnessing the execution of an affirmation or
acknowledgment of parentage
The bill allows DSS’s eligibility workers, specialists, and supervisors
to administer oaths for the sole purpose of witnessing the execution of
an affirmation or acknowledgment of parentage when their assigned
duties include doing so. In practice, establishing children’s parentage is
part of the cash assistance application process under DSS’s TFA
program.
Existing law authorizes various individuals to administer oaths,
including House and Senate clerks, municipal chief elected officials, and
investigators employed by DSS’s Office of Child Support Services.
EFFECTIVE DATE: Upon passage.
Background ― Related Bill
SB 193 (File 216), favorably reported by the Human Services
Committee, has near identical provisions regarding DSS eligibility
workers administering oaths.
§ 503 ― OPENING OR SETTING ASIDE OF A PARENTAGE
JUDGMENT
Establishes the circumstances under which the Superior Court or family support
magistrate may open or set aside a judgement of parentage
The bill establishes the circumstances under which the Superior
Court or family support magistrate may open or set aside a judgement
of parentage. Under the bill, motions to open or set aside an existing
judgment generally must be filed within four months after the date the
court or family support magistrate entered the judgment. The bill allows
the court or family support magistrate to open or set aside the judgment
if (1) there is reasonable cause or (2) a valid defense to the petition 2022SB-00286-R01-BA.DOCX
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existed, in whole or in part, when the judgement was rendered, and a
mistake, accident, or other reasonable cause prevented the person
seeking to open or set aside the judgment from making a valid defense.
The bill allows the Superior Court or family support magistrate to
consider a motion to open or set aside a parentage judgment filed more
than four months after the judgment if the court or magistrate finds the
judgment was entered due to fraud, duress, or a material mistake of fact.
The bill places the burden of proof on the person seeking to open or set
aside the judgment. Under the bill, after determining the person meets
the burden of proof, the court or family support magistrate may only set
aside the judgment if doing so is in the child’s best interest, based on
factors under the Connecticut Parentage Act.
EFFECTIVE DATE: July 1, 2022
Background ― Adjudicating Parentage under the Connecticut
Parentage Act
By law, in a proceeding to adjudicate competing parentage claims for
a child by two or more persons, the court must adjudicate parentage in
the child’s best interest, based on the following:
1. the child’s age,
2. the length of time during which each person assumed the role of
the child’s parent,
3. the nature of the relationship between the child and each person,
4. harm to the child if the relationship between the child and each
person is not recognized,
5. the basis for each person’s claim to parentage,
6. other equitable factors arising from disrupting the relationship
between the child and each person or the likelihood of other
harm to the child, and
7. any other factor the court deems relevant to the child’s best 2022SB-00286-R01-BA.DOCX
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interests (CGS § 46b-475).
Background ― Related Bill
sSB 199 (File 363), favorably reported by the Human Services and
Judiciary committees, has identical provisions regarding the opening or
setting aside of a parentage judgment.
§ 504 ― PENALTIES FOR UNAUTHORIZED USE OF RATE
INCREASES EARMARKED FOR NURSING HOME STAFF WAGE
ENHANCEMENTS
Allows DSS to assess a civil penalty on a nursing home that receives a rate increase to
enhance its employees’ wages but fails to use it for that purpose
The bill allows DSS to assess a civil penalty on a nursing home that
receives a rate increase to enhance its employees’ wages but fails to use
it for that purpose. The civil penalty is in addition to any applicable
recoupment or rate decrease the law otherwise allows.
Before assessing a civil penalty, the bill requires DSS to complete a
department audit in accordance with the nursing home’s Medicaid
provider enrollment agreements. The bill limits the civil penalty to half
the total dollar amount of the rate increase the nursing home received
but did not use to enhance employee wages. It authorizes DSS, in the
department’s sole discretion, to enter a recoupment schedule with a
nursing home so as not to negatively impact patient care. Nursing
homes subject to a civil penalty may request a rehearing under
provisions in existing law (see BACKGROUND).
DSS’s authorization to assess civil penalties under the bill applies to
rate increases nursing homes receive before the bill’s effective date
under last year’s budget (PA 21-2, June Special Session, § 323). That act
required DSS to increase nursing home rates by 4.5% in both FY 22 and
FY 23 to enhance wages for employees. Under the act, facilities that
received a rate adjustment for wage enhancements but failed to provide
them may be subject to a rate decrease in the same amount.
EFFECTIVE DATE: Upon passage
Background ― Rehearing a Rate Decision 2022SB-00286-R01-BA.DOCX
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State law allows nursing homes aggrieved by a DSS decision to apply
for a rehearing within 10 days after the written notice of DSS’s decision.
Nursing homes must file a detailed written description of all items of
aggrievement with DSS within 90 days after the written notice. DSS
must issue a final decision within 60 days after the close of evidence or
the date on which final briefs are filed, whichever is later. Items not
resolved at the rehearing are submitted to binding arbitration (CGS §
17b-238(b)).
Background ― Related Bill
SB 281 (File 151), favorably reported by the Human Services and
Judiciary committees, has identical provisions on penalties for
unauthorized use of rate increases earmarked for nursing home staff
wage enhancements.
§§ 505-508 ― CERTIFICATES OF NEED FO R LONG-TERM CARE
FACILITIES
Makes various changes to the DSS certificate of need (CON) process for certain long-term
care facilities, including allowing DSS to approve requests to build nontraditional, small-
house style nursing homes under certain conditions
The bill makes various changes to the DSS’s certificate of need (CON)
process for certain long-term care facilities. By law, nursing homes,
residential care homes, rest homes, and intermediate care facilities for
people with intellectual disabilities must generally receive DSS
approval when (1) introducing new services, (2) changing ownership,
(3) relocating licensed beds or decreasing bed capacity, (4) terminating
a service, or (5) incurring certain capital expenditures.
Among other things, the bill allows DSS to approve requests to build
nontraditional, small-house style nursing homes under certain
conditions and establishes factors DSS must consider when deciding on
these requests. It also broadens other exemptions to the general
moratorium on nursing home beds.
The bill adds additional criteria that DSS must consider when
evaluating certain types of CON requests, including requests to relocate
beds. 2022SB-00286-R01-BA.DOCX
Researcher: JP Page 9 5/4/22
The bill allows the DSS commissioner to place conditions on any
decision approving or modifying a CON request as she deems
necessary. It also allows DSS to hold an informal conference with the
facility when reviewing a request to discuss the CON application. If the
commissioner modifies the request, the bill requires her to notify the
facility before issuing the decision and provide an opportunity for an
informal conference to discuss the modifications.
The bill subjects adverse CON decisions to provisions on proposed
final decisions under the state’s Uniform Administrative Procedures Act
(UAPA).
The bill also makes minor changes to timing and notification
requirements for public hearings and makes other technical and
conforming changes.
By law, the DSS commissioner must adopt regulations to implement
the CON process provisions and may adopt regulations on the nursing
home bed moratorium provisions.
EFFECTIVE DATE: July 1, 2022
Nursing Home Bed Moratorium
Existing law establishes a nursing home bed moratorium that
generally prohibits DSS from accepting or approving requests for
additional nursing home beds, with certain exceptions. The bill adds a
new exception that allows DSS to approve a proposal to build a
nontraditional, small-house style nursing home designed to enhance the
quality of life for residents as long as the facility agrees to reduce its total
number of licensed beds by a percentage the DSS commissioner
determines in accordance with DSS’s strategic plan for long-term care.
The bill also broadens two existing exceptions. One exception allows
DSS to approve beds associated with a continuing care facility that are
not used in the Medicaid program. For this exception, the bill eliminates
a requirement that the ratio of proposed nursing home beds to the
continuing care facility’s independent living units be within applicable
industry standards. For these facilities, the bill also eliminates a 2022SB-00286-R01-BA.DOCX
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requirement that DSS only consider the need for beds for current and
prospective continuing care facility residents when considering whether
there is clear public need for additional nursing home beds.
Another exception allows DSS to approve licensed Medicaid nursing
facility beds that will be relocated from existing facilities to a new facility
under certain criteria (see below). The bill additionally allows DSS to
approve facilities relocated to a replacement facility under this
exception.
By law, the moratorium exception that allows DSS to approve
relocation of nursing home beds only applies if:
1. no new Medicaid certified beds are added;
2. due to the relocation, at least one currently licensed facility is
closed in the transaction;
3. the relocation is done within available appropriations;
4. the facility participates in the Money Follows the Person
demonstration project;
5. the relocation will not adversely affect bed availability in the area
of need;
6. the facility receives an approved CON and obtains associated
capital expenditures; and
7. the facilities included in the bed relocation and closure are in
accordance with the long-term care strategic plan.
Under the bill, as is generally the case under the moratorium, a
proposal to relocate a nursing home bed from an existing facility to a
new facility may not increase the number of Medicaid certified beds.
The bill also requires that the proposal result in a closure of at least one
currently licensed facility.
Additionally, the bill requires the DSS commissioner to consider the
above criteria when evaluating a CON request to relocate licensed 2022SB-00286-R01-BA.DOCX
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nursing facility beds from an existing facility to another licensed facility
or a new or replacement facility. Under the bill, she must also consider
priority needs identified in the long-term care strategic plan.
Factors Considered in CON Decisions
By law, when determining whether to grant, modify, or deny a CON
application, the DSS commissioner must consider several factors,
including:
1. the request’s financial feasibility and impact on the applicant’s
rates and financial condition;
2. whether there is a clear public need for the request;
3. the relationship of any proposed change to the applicant’s
current utilization statistics;
4. the business interests and personal background of all owners,
partners, associates, incorporators, directors, sponsors,
stockholders, and operators; and
5. any other factor DSS deems relevant.
The bill requires DSS to consider how the request contributes to the
quality, accessibility, and cost-effectiveness of long-term care delivery,
rather than health care delivery. It additionally requires DSS to consider
the proposal’s effect on utilization statistics for other facilities in the
applicant’s service area. The bill eliminates requirements that DSS
consider the request’s relationship to the state health plan and include a
written explanation in its decision when the decision conflicts with the
plan.
Current law requires DSS, when determining whether there is a
public need for a request to relocate beds, to consider whether there is a
demonstrated bed need in the towns within a 15-mile radius of the town
where the proposal would relocate beds. The bill specifies that this only
applies to a request to relocate beds to a replacement facility, and
additionally requires DSS to consider whether the proposal will 2022SB-00286-R01-BA.DOCX
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adversely affect bed availability in the applicant’s service area.
For applications to establish a new or replacement nursing facility,
the bill requires DSS to consider whether the proposed facility is a
nontraditional, small-house style nursing facility and incorporates goals
for nursing facilities under the long-term care strategic plan, including:
1. promoting person-centered care,
2. providing enhanced quality of care,
3. creating community space for residents, and
4. developing stronger connections between residents and the
surrounding community.
Informal Conferences and Approval Conditions
By law, the DSS commissioner must grant, modify, or deny a CON
request within 90 days after receiving it, with certain exceptions. The bill
allows DSS to hold an informal conference with the facility while it
reviews the request to discuss the CON application. Under the bill, if the
DSS commissioner modifies the request, she must notify the facility
before issuing the decision and provide the applicant with an
opportunity for an informal conference to discuss the modifications.
The bill also allows the DSS commissioner to place conditions on any
decision approving or modifying a CON request as she deems
necessary, including project and Medicaid reimbursement details and
applicant requirements for summary and audit purposes.
CON Process for Capital Expenditures
Existing law establishes a similar process for facilities to request a
CON from DSS to incur capital expenditures over $2 million or over $1
million if the expenditure increases the facility’s square footage by 5,000
square feet or 5% of the existing square footage, whichever is larger.
Like the process described above, the DSS commissioner must grant,
modify, or deny a request within 90 days, with certain exceptions. The
bill allows her to place conditions on any decision approving or 2022SB-00286-R01-BA.DOCX
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modifying a request as she deems necessary to address specified
concerns, including project and Medicaid reimbursement details and
applicant requirements for summary and audit purposes. However,
existing law, unchanged by the bill, prohibits the commissioner, or her
designee, from prescribing any condition not directly related to the
capital program’s scope and within the facility’s control. The law
explicitly prohibits any condition or limitation on the facility’s
indebtedness in connection with a bond issued, the principal amount of
any bond issued, or any other details or particulars related to the capital
expenditure’s financing.
Additional DSS Stipulations
For CON applications, the bill allows the DSS commissioner to
request that any applicant seeking to replace an existing facility reduce
the number of beds in the new facility by a percentage consistent with
the long-term care strategic plan. If the applicant owns or operates more
than one nursing facility and seeks to replace an existing facility with a
new facility, the bill allows the DSS commissioner to request that the
applicant close two or more facilities before approving a proposal to
build a new one.
Adverse Proposed Final Decisions
Under the bill, for all CON requests, if the DSS commissioner’s
designee recommends denying the request, the decision is subject to
provisions on proposed final decisions under the state’s Uniform
Administrative Procedure Act (UAPA).
Under these UAPA provisions, if a majority of agency members who
will render a final decision have not heard the matter or read the record,
the decision, if adverse to the facility, may not be rendered until a
proposed final decision is served on the parties and each has an
opportunity to file exceptions and present briefs and oral argument to
agency members who will render the final decision. These proposed
final decisions must be in writing and include reasons for the decision,
finding of facts, and a legal conclusion on each issue of fact or law
necessary to the decision (CGS § 4-179). 2022SB-00286-R01-BA.DOCX
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Public Hearing Notice and Timing
For CON requests other than those to relocate beds, existing law
requires that the DSS commissioner or her designee hold a public
hearing. Current law requires her to do so within 30 days after receiving
either a letter of intent or a CON application, whichever is received first.
The bill instead requires her to do so within 30 days after receiving a
CON application.
Additionally, the bill (1) decreases, from 14 to 10 days, the amount of
advance notice DSS must provide the facility and the public before the
hearing and (2) requires DSS to notify the facility by email or first-class
mail rather than certified mail.
Background ― Related Bill
sSB 290 (File 399), favorably reported by the Human Services
Committee, has near identical provisions regarding certificates of need
for long-term care facilities.
COMMITTEE ACTION
Human Services Committee
Joint Favorable Substitute
Yea 20 Nay 0 (03/17/2022)