Connecticut 2022 Regular Session

Connecticut Senate Bill SB00286 Compare Versions

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	7	+	General Assembly Substitute Bill No. 286
	8	+	February Session, 2022
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4		-	Substitute Senate Bill No. 286
5		-
6		-	Public Act No. 22-145
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8	13
9		-	AN ACT CONCERNING ELDER ABUSE REPORTING DEADLINES,
10		-	TEMPORARY FAMILY ASSISTANCE, CERTIFICATES OF NEED
11		-	FOR LONG-TERM CARE FACILITIES AND CIVIL PENALTIES FOR
12		-	NURSING HOMES THAT FAIL TO USE RATE INCREASES FOR
13		-	EMPLOYEE WAGE ENHANCEMENTS.
	14	+	AN ACT CONCERNING DEADLINES FOR MANDATORY REPORTING
	15	+	OF SUSPECTED ELDER ABUSE AND PENALTIES FOR FAILURE TO
	16	+	REPORT.
14	17		Be it enacted by the Senate and House of Representatives in General
15	18		Assembly convened:
16	19
17		-	Section 1. Subsection (a) of section 17b-451 of the 2022 supplement to
18		-	the general statutes is repealed and the following is substituted in lieu
19		-	thereof (Effective July 1, 2022):
20		-	(a) A mandatory reporter who has reasonable cause to suspect or
21		-	believe that any elderly person has been abused, neglected, exploited or
22		-	abandoned, or is in a condition that is the result of such abuse, neglect,
23		-	exploitation or abandonment, or is in need of protective services, shall,
24		-	not later than [seventy-two] twenty-four hours after such suspicion or
25		-	belief arose, report such information or cause a report to be made in any
26		-	reasonable manner to the Commissioner of Social Services or to the
27		-	person or persons designated by the commissioner to receive such
28		-	reports. Any mandatory reporter who fails for the first time to make
29		-	such report within the prescribed time shall [be fined not more than five
30		-	hundred dollars, except that, if] retake the mandatory training on
31		-	detecting potential abuse, neglect, exploitation and abandonment of Substitute Senate Bill No. 286
	20	+	Section 1. Subsection (a) of section 17b-451 of the 2022 supplement to 1
	21	+	the general statutes is repealed and the following is substituted in lieu 2
	22	+	thereof (Effective July 1, 2022): 3
	23	+	(a) A mandatory reporter who has reasonable cause to suspect or 4
	24	+	believe that any elderly person has been abused, neglected, exploited or 5
	25	+	abandoned, or is in a condition that is the result of such abuse, neglect, 6
	26	+	exploitation or abandonment, or is in need of protective services, shall, 7
	27	+	not later than [seventy-two] twenty-four hours after such suspicion or 8
	28	+	belief arose, report such information or cause a report to be made in any 9
	29	+	reasonable manner to the Commissioner of Social Services or to the 10
	30	+	person or persons designated by the commissioner to receive such 11
	31	+	reports. Any mandatory reporter who fails for the first time to make 12
	32	+	such report within the prescribed time shall [be fined not more than five 13
	33	+	hundred dollars, except that, if] retake the mandatory training on 14
	34	+	detecting potential abuse, neglect, exploitation and abandonment of 15
	35	+	elderly persons and provide the commissioner with proof of successful 16
	36	+	completion of such training. Any mandatory reporter who subsequently 17 Substitute Bill No. 286
32	37
33		-	Public Act No. 22-145 2 of 19
34	38
35		-	elderly persons and provide the commissioner with proof of successful
36		-	completion of such training. Any mandatory reporter who subsequently
37		-	fails to make such report within the prescribed time period shall be fined
38		-	not more than five hundred dollars and shall retake the mandatory
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	43	+	fails to make such report within the prescribed time period shall be fined 18
	44	+	not more than five hundred dollars and shall retake the mandatory 19
	45	+	training on detecting potential abuse, neglect, exploitation and 20
	46	+	abandonment of elderly persons and provide the commissioner with 21
	47	+	proof of successful completion of such training. If such person 22
	48	+	intentionally fails to make such report within the prescribed time 23
	49	+	period, such person shall be guilty of a class C misdemeanor for the first 24
	50	+	offense and a class A misdemeanor for any subsequent offense. Any 25
	51	+	institution, organization, agency or facility employing individuals to 26
	52	+	care for persons sixty years of age or older shall provide mandatory 27
	53	+	training on detecting potential abuse, neglect, exploitation and 28
	54	+	abandonment of such persons and inform such employees of their 29
	55	+	obligations under this section. For purposes of this subsection, 30
	56	+	"mandatory reporter" means any (1) physician or surgeon licensed 31
	57	+	under the provisions of chapter 370, (2) resident physician or intern in 32
	58	+	any hospital in this state, whether or not so licensed, (3) registered nurse, 33
	59	+	(4) nursing home administrator, nurse's aide or orderly in a nursing 34
	60	+	home facility or residential care home, (5) person paid for caring for a 35
	61	+	resident in a nursing home facility or residential care home, (6) staff 36
	62	+	person employed by a nursing home facility or residential care home, 37
	63	+	(7) residents' advocate, other than a representative of the Office of the 38
	64	+	Long-Term Care Ombudsman, as established under section 17a-405, 39
	65	+	including the State Ombudsman, (8) licensed practical nurse, medical 40
	66	+	examiner, dentist, optometrist, chiropractor, podiatrist, social worker, 41
	67	+	clergyman, police officer, pharmacist, psychologist or physical 42
	68	+	therapist, (9) person paid for caring for an elderly person by any 43
	69	+	institution, organization, agency or facility, including but not limited to, 44
	70	+	any employee of a community-based services provider, senior center, 45
	71	+	home care agency, homemaker and companion agency, adult day care 46
	72	+	center, village-model community and congregate housing facility, (10) 47
	73	+	person licensed or certified as an emergency medical services provider 48
	74	+	pursuant to chapter 368d or 384d, including any such emergency 49
	75	+	medical services provider who is a member of a municipal fire 50
	76	+	department, and (11) driver of a paratransit vehicle, as defined in section 51
	77	+	13b-38k. 52 Substitute Bill No. 286
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	84	+	This act shall take effect as follows and shall amend the following
	85	+	sections:
	86	+
	87	+	Section 1 July 1, 2022 17b-451(a)
	88	+
	89	+
	90	+	Statement of Legislative Commissioners:
	91	+	In Subsec. (a), "elder abuse training" was changed to "mandatory
39	92		training on detecting potential abuse, neglect, exploitation and
40		-	abandonment of elderly persons and provide the commissioner with
41		-	proof of successful completion of such training. If such person
42		-	intentionally fails to make such report within the prescribed time
43		-	period, such person shall be guilty of a class C misdemeanor for the first
44		-	offense and a class A misdemeanor for any subsequent offense. Any
45		-	institution, organization, agency or facility employing individuals to
46		-	care for persons sixty years of age or older shall provide mandatory
47		-	training on detecting potential abuse, neglect, exploitation and
48		-	abandonment of such persons and inform such employees of their
49		-	obligations under this section. For purposes of this subsection,
50		-	"mandatory reporter" means any (1) physician or surgeon licensed
51		-	under the provisions of chapter 370, (2) resident physician or intern in
52		-	any hospital in this state, whether or not so licensed, (3) registered nurse,
53		-	(4) nursing home administrator, nurse's aide or orderly in a nursing
54		-	home facility or residential care home, (5) person paid for caring for a
55		-	resident in a nursing home facility or residential care home, (6) staff
56		-	person employed by a nursing home facility or residential care home,
57		-	(7) residents' advocate, other than a representative of the Office of the
58		-	Long-Term Care Ombudsman, as established under section 17a-405,
59		-	including the State Ombudsman, (8) licensed practical nurse, medical
60		-	examiner, dentist, optometrist, chiropractor, podiatrist, social worker,
61		-	clergyman, police officer, pharmacist, psychologist or physical
62		-	therapist, (9) person paid for caring for an elderly person by any
63		-	institution, organization, agency or facility, including but not limited to,
64		-	any employee of a community-based services provider, senior center,
65		-	home care agency, homemaker and companion agency, adult day care
66		-	center, village-model community and congregate housing facility, (10)
67		-	person licensed or certified as an emergency medical services provider Substitute Senate Bill No. 286
	93	+	abandonment of elderly persons" for consistency.
68	94
69		-	~~Public Act No. 22-145 3 of 19~~
	95	+	HS
70	96
71		-	pursuant to chapter 368d or 384d, including any such emergency
72		-	medical services provider who is a member of a municipal fire
73		-	department, and (11) driver of a paratransit vehicle, as defined in section
74		-	13b-38k.
75		-	Sec. 2. Subsection (b) of section 17b-688c of the general statutes is
76		-	repealed and the following is substituted in lieu thereof (Effective July 1,
77		-	2022):
78		-	(b) In no event shall temporary family assistance be granted to an
79		-	applicant for such assistance, who is not exempt from participation in
80		-	the employment services program, prior to the applicant's attendance at
81		-	an initial scheduled employment services assessment interview and
82		-	participation in the development of an employment services plan. The
83		-	Department of Social Services shall [not delay temporary family
84		-	assistance to an applicant in cases where the department schedules]
85		-	promptly conduct an application interview with an applicant for
86		-	temporary family assistance to determine whether such applicant is
87		-	exempt from participation in the employment services program. If the
88		-	department determines that such applicant is not exempt, the
89		-	department shall schedule the initial employment services assessment
90		-	interview not later than ten business days after the date of the
91		-	application interview. In cases where the department does not schedule
92		-	the initial employment services assessment interview [more than]
93		-	within ten business days [after] of the date on which the application [for
94		-	assistance is made, or in cases where] interview was completed, or
95		-	where the Labor Department does not complete an employment
96		-	services plan for the benefit of the applicant within ten business days of
97		-	the date on which the applicant attends an employment services
98		-	assessment interview, the Department of Social Services shall not delay
99		-	granting temporary family assistance to an applicant who is otherwise
100		-	eligible for such assistance. The Commissioner of Social Services shall
101		-	refer any applicant denied temporary family assistance, who may be in Substitute Senate Bill No. 286
	97	+	Joint Favorable Subst.
102	98
103		-	Public Act No. 22-145 4 of 19
104		-
105		-	need of emergency benefits, to other services offered by the Department
106		-	of Social Services or community services that may be available to such
107		-	applicant. The Department of Social Services shall reduce the benefits
108		-	awarded to a family under the temporary family assistance program
109		-	when a member of the family who is required to participate in the
110		-	employment services program fails to comply with an employment
111		-	services requirement without good cause. [The first instance of
112		-	noncompliance with an employment services requirement shall result
113		-	in a twenty-five per cent reduction of such benefits for three consecutive
114		-	months. The second instance of noncompliance with such requirement
115		-	shall result in a thirty-five per cent reduction of such benefits for three
116		-	consecutive months. A third or subsequent instance of noncompliance
117		-	with such requirement shall result in the termination of such benefits
118		-	for three consecutive months.] The Department of Social Services shall
119		-	impose this reduction by excluding the noncompliant family member
120		-	from the household when calculating the family's monthly benefit. Such
121		-	exclusion shall continue until the noncompliant family member (1)
122		-	begins to comply with employment services requirements, (2) becomes
123		-	exempt from such requirements, or (3) demonstrates good cause for his
124		-	or her failure to comply with such requirements. If only one member of
125		-	a family is eligible for temporary family assistance and such member
126		-	fails without good cause to comply with an employment services
127		-	requirement, the department shall [terminate all benefits of such family
128		-	for three consecutive months Notwithstanding the provisions of this
129		-	subsection, the department shall terminate the benefits awarded to a
130		-	family under the temporary family assistance program if a member of
131		-	the family who is not exempt from the twenty-one-month time limit
132		-	specified in subsection (a) of section 17b-112 fails, without good cause,
133		-	to: (1) Attend any scheduled assessment appointment or interview
134		-	relating to the establishment of an employment services plan, except
135		-	that such individual's benefits shall be reinstated if the individual
136		-	attends a subsequently scheduled appointment or interview within
137		-	thirty days of the date on which the department has issued notification Substitute Senate Bill No. 286
138		-
139		-	Public Act No. 22-145 5 of 19
140		-
141		-	to the individual that benefits have been terminated, or (2) comply with
142		-	an employment services requirement during a six-month extension of
143		-	benefits. Any individual who fails to comply with the provisions of
144		-	subdivision (1) of this subsection may submit a new application for such
145		-	benefits at any time after termination of benefits] reduce such family's
146		-	benefit by twenty-five per cent for each month such member fails to
147		-	comply.
148		-	Sec. 3. Section 1-24 of the general statutes is repealed and the
149		-	following is substituted in lieu thereof (Effective from passage):
150		-	The following officers may administer oaths: (1) The clerks of the
151		-	Senate, the clerks of the House of Representatives and the chairpersons
152		-	of committees of the General Assembly or of either branch thereof,
153		-	during its session; (2) state officers, as defined in subsection (t) of section
154		-	9-1, judges and clerks of any court, family support magistrates, judge
155		-	trial referees, justices of the peace, commissioners of the Superior Court,
156		-	notaries public, town clerks and assistant town clerks, in all cases where
157		-	an oath may be administered, except in a case where the law otherwise
158		-	requires; (3) commissioners on insolvent estates, auditors, arbitrators
159		-	and committees, to parties and witnesses, in all cases tried before them;
160		-	(4) assessors and boards of assessment appeals, in cases coming before
161		-	them; (5) commissioners appointed by governors of other states to take
162		-	the acknowledgment of deeds, in the discharge of their official duty; (6)
163		-	the moderator of a school district meeting, in such meeting, to the clerk
164		-	of such district, as required by law; (7) the chief elected official of a
165		-	municipality, in any matter before the chief elected official of a
166		-	municipality; (8) the Chief Medical Examiner, Deputy Medical
167		-	Examiner and assistant medical examiners of the Office of the Medical
168		-	Examiner, in any matter before them; (9) registrars of vital statistics, in
169		-	any matter before them; (10) any chief inspector or inspector appointed
170		-	pursuant to section 51-286; (11) registrars of voters, deputy registrars,
171		-	assistant registrars, and moderators, in any matter before them; (12) Substitute Senate Bill No. 286
172		-
173		-	Public Act No. 22-145 6 of 19
174		-
175		-	special assistant registrars, in matters provided for in subsections (b)
176		-	and (c) of section 9-19b and section 9-19c; (13) the Commissioner of
177		-	Emergency Services and Public Protection and any sworn member of
178		-	any local police department or the Division of State Police within the
179		-	Department of Emergency Services and Public Protection, in all
180		-	affidavits, statements, depositions, complaints or reports made to or by
181		-	any member of any local police department or said Division of State
182		-	Police or any constable who is under the supervision of said
183		-	commissioner or any of such officers of said Division of State Police and
184		-	who is certified under the provisions of sections 7-294a to 7-294e,
185		-	inclusive, and performs criminal law enforcement duties; (14) judge
186		-	advocates of the United States Army, Navy, Air Force and Marine
187		-	Corps, law specialists of the United States Coast Guard, adjutants,
188		-	assistant adjutants, acting adjutants and personnel adjutants,
189		-	commanding officers, executive officers and officers whose rank is
190		-	lieutenant commander or major, or above, of the armed forces, as
191		-	defined in section 27-103, to persons serving with or in the armed forces,
192		-	as defined in said section, or their spouses; (15) investigators, deputy
193		-	investigators, investigative aides, secretaries, clerical assistants, social
194		-	workers, social worker trainees, paralegals and certified legal interns
195		-	employed by or assigned to the Public Defender Services Commission
196		-	in the performance of their assigned duties; (16) bail commissioners,
197		-	intake, assessment and referral specialists, family relations counselors,
198		-	support enforcement officers, chief probation officers and supervisory
199		-	judicial marshals employed by the Judicial Department in the
200		-	performance of their assigned duties; (17) juvenile matter investigators
201		-	employed by the Division of Criminal Justice in the performance of their
202		-	assigned duties; (18) the chairperson of the Connecticut Siting Council
203		-	or the chairperson's designee; (19) the presiding officer at an agency
204		-	hearing under section 4-177b; (20) investigators employed by the
205		-	Department of Social Services Office of Child Support Services, in the
206		-	performance of their assigned duties; (21) the chairperson, vice-
207		-	chairperson, members and employees of the Board of Pardons and Substitute Senate Bill No. 286
208		-
209		-	Public Act No. 22-145 7 of 19
210		-
211		-	Paroles, in the performance of their assigned duties; (22) the
212		-	Commissioner of Correction or the commissioner's designee; (23) sworn
213		-	law enforcement officers, appointed under section 26-5, within the
214		-	Department of Energy and Environmental Protection, in all affidavits,
215		-	statements, depositions, complaints or reports made to or by any such
216		-	sworn law enforcement officer; [and] (24) sworn motor vehicle
217		-	inspectors acting under the authority of section 14-8; and (25) eligibility
218		-	workers, specialists and supervisors employed by the Department of
219		-	Social Services for the sole purpose of witnessing the execution of an
220		-	affirmation or acknowledgment of parentage when their assigned
221		-	duties include witnessing such execution.
222		-	Sec. 4. Subsection (b) of section 46b-171 of the 2022 supplement to the
223		-	general statutes is repealed and the following is substituted in lieu
224		-	thereof (Effective July 1, 2022):
225		-	(b) (1) Except as provided in subdivision (2) of this subsection, a
226		-	judgment of parentage entered by the Superior Court or family support
227		-	magistrate pursuant to this chapter may not be opened or set aside
228		-	unless (A) a motion to open or set aside is filed not later than four
229		-	months after the date on which the judgment was entered, and (B) upon
230		-	a showing (i) of reasonable cause, or (ii) that a valid defense to the
231		-	petition for a judgment of parentage existed, in whole or in part, at the
232		-	time judgment was rendered, and the person seeking to open or set
233		-	aside the judgment was prevented by mistake, accident or other
234		-	reasonable cause from making a valid defense.
235		-	(2) The Superior Court or a family support magistrate may consider
236		-	a motion to open or set aside a judgment of parentage filed more than
237		-	four months after such judgment was entered if such court or magistrate
238		-	determines that the judgment was entered due to fraud, duress or
239		-	material mistake of fact. The burden of proof shall be on the person
240		-	seeking to open or set aside such judgment. If the court or family
241		-	support magistrate determines such person has met the burden of proof Substitute Senate Bill No. 286
242		-
243		-	Public Act No. 22-145 8 of 19
244		-
245		-	under this subdivision, the judgment shall be set aside only if the court
246		-	or family support magistrate determines that doing so is in the best
247		-	interest of the child, based on the relevant factors set forth in section 46b-
248		-	475.
249		-	[(b)] (3) Whenever the Superior Court or family support magistrate
250		-	[reopens] opens a judgment of parentage entered pursuant to this
251		-	section in which a person was found to be the parent of a child who is
252		-	or has been supported by the state and the court or family support
253		-	magistrate finds that the person adjudicated the parent is not the parent
254		-	of the child, the Department of Social Services shall refund to such
255		-	person any money paid to the state by such person during the period
256		-	such child was supported by the state.
257		-	Sec. 5. (NEW) (Effective from passage) (a) In addition to any applicable
258		-	recoupment or rate decrease pursuant to any other provision of the
259		-	general statutes, a nursing home facility that receives a rate increase for
260		-	wage enhancements for facility employees may also be assessed a civil
261		-	penalty if the facility fails to use the rate increase for that purpose. The
262		-	Department of Social Services may assess a civil penalty upon
263		-	completion of a department audit conducted in accordance with the
264		-	nursing home facility's Medicaid provider enrollment agreements. The
265		-	civil penalty assessed pursuant to this section shall not exceed an
266		-	amount greater than fifty per cent of the total dollar amount of the rate
267		-	increase received by the nursing home facility but not used for wage
268		-	enhancements for facility employees.
269		-	(b) The department, in its sole discretion, may enter into a
270		-	recoupment schedule with a nursing home facility so as not to
271		-	negatively impact patient care. Any nursing home facility subject to a
272		-	civil penalty assessed in accordance with this section may request a
273		-	rehearing pursuant to subsection (b) of section 17b-238 of the general
274		-	statutes. The provisions of this section shall apply to all rate increases
275		-	for wage enhancements received by nursing home facilities pursuant to Substitute Senate Bill No. 286
276		-
277		-	Public Act No. 22-145 9 of 19
278		-
279		-	the provisions of section 323 of public act 21-2 of the June special session
280		-	prior to the effective date of this section.
281		-	Sec. 6. Section 17b-352 of the general statutes is repealed and the
282		-	following is substituted in lieu thereof (Effective July 1, 2022):
283		-	(a) For the purposes of this section and section 17b-353, as amended
284		-	by this act, "facility" means a residential facility for persons with
285		-	intellectual disability licensed pursuant to section 17a-277 and certified
286		-	to participate in the Title XIX Medicaid program as an intermediate care
287		-	facility for individuals with intellectual disabilities, a nursing home, rest
288		-	home or residential care home, as defined in section 19a-490. "Facility"
289		-	does not include a nursing home that does not participate in the
290		-	Medicaid program and is associated with a continuing care facility as
291		-	described in section 17b-520.
292		-	(b) Any facility which intends to (1) transfer all or part of its
293		-	ownership or control prior to being initially licensed; (2) introduce any
294		-	additional function or service into its program of care or expand an
295		-	existing function or service; (3) terminate a service or decrease
296		-	substantially its total licensed bed capacity; or (4) relocate all or a portion
297		-	of such facility's licensed beds, to a new facility or replacement facility,
298		-	shall submit a complete request for permission to implement such
299		-	transfer, addition, expansion, increase, termination, decrease or
300		-	relocation of facility beds to the Department of Social Services with such
301		-	information as the department requires, provided no permission or
302		-	request for permission to close a facility is required when a facility in
303		-	receivership is closed by order of the Superior Court pursuant to section
304		-	19a-545. The Commissioner of Social Services shall consider the criteria
305		-	in subdivisions (3) and (4) of subsection (a) of section 17b-354, as
306		-	amended by this act, when evaluating a certificate of need request to
307		-	relocate licensed nursing facility beds from an existing facility to another
308		-	licensed nursing facility or to a new facility or replacement facility. The
309		-	Office of the Long-Term Care Ombudsman pursuant to section 17a-405 Substitute Senate Bill No. 286
310		-
311		-	Public Act No. 22-145 10 of 19
312		-
313		-	shall be notified by the facility of any proposed actions pursuant to this
314		-	subsection at the same time the request for permission is submitted to
315		-	the department and when a facility in receivership is closed by order of
316		-	the Superior Court pursuant to section 19a-545.
317		-	(c) A facility may submit a petition for closure to the Department of
318		-	Social Services. The Department of Social Services may authorize the
319		-	closure of a facility if the facility's management demonstrates to the
320		-	satisfaction of the Commissioner of Social Services in the petition for
321		-	closure that the facility (1) is not viable based on actual and projected
322		-	operating losses; (2) has an occupancy rate of less than seventy per cent
323		-	of the facility's licensed bed capacity; (3) closure is consistent with the
324		-	strategic rebalancing plan developed in accordance with section 17b-
325		-	369, including bed need by geographical region; (4) is in compliance
326		-	with the requirements of Sections 1128I(h) and 1819(h)(4) of the Social
327		-	Security Act and 42 CFR 483.75; and (5) is not providing special services
328		-	that would go unmet if the facility closes. The department shall review
329		-	a petition for closure to the extent it deems necessary and the facility
330		-	shall submit information the department requests or deems necessary
331		-	to substantiate that the facility closure is consistent with the provisions
332		-	of this subsection. The facility shall submit information the department
333		-	requests or deems necessary to allow the department to provide
334		-	oversight during this process. The Office of the Long-Term Care
335		-	Ombudsman shall be notified by the facility at the same time as a
336		-	petition for closure is submitted to the department. Any facility acting
337		-	pursuant to this subsection shall provide written notice, on the same
338		-	date that the facility submits its petition for closure, to all patients,
339		-	guardians or conservators, if any, or legally liable relatives or other
340		-	responsible parties, if known, and shall post such notice in a
341		-	conspicuous location at the facility. The facility's written notice shall be
342		-	accompanied by an informational letter issued jointly from the Office of
343		-	the Long-Term Care Ombudsman and the Department of Rehabilitation
344		-	Services on patients' rights and services available as they relate to the Substitute Senate Bill No. 286
345		-
346		-	Public Act No. 22-145 11 of 19
347		-
348		-	petition for closure. The informational letter shall also state the date and
349		-	time that the Office of the Long-Term Care Ombudsman and the
350		-	Department of Public Health will hold an informational session at the
351		-	facility for patients, guardians or conservators, if any, and legally liable
352		-	relatives or other responsible parties, if known, about their rights and
353		-	the process concerning a petition for closure. The notice shall state: (A)
354		-	The date the facility submitted the petition for closure, (B) that only the
355		-	Department of Social Services has the authority to either grant or deny
356		-	the petition for closure, (C) that the Department of Social Services has
357		-	up to thirty days to grant or deny the petition for closure, (D) a brief
358		-	description of the reason or reasons for submitting the petition for
359		-	closure, (E) that no patient shall be involuntarily transferred or
360		-	discharged within or from a facility pursuant to state and federal law
361		-	because of the filing of a petition for closure, (F) that all patients have a
362		-	right to appeal any proposed transfer or discharge, and (G) the name,
363		-	mailing address and telephone number of the Office of the Long-Term
364		-	Care Ombudsman and local legal aid office. The commissioner shall
365		-	grant or deny a petition for closure within thirty days of receiving such
366		-	request.
367		-	(d) An applicant, prior to submitting a certificate of need application,
368		-	shall request, in writing, application forms and instructions from the
369		-	department. The request shall include: (1) The name of the applicant or
370		-	applicants; (2) a statement indicating whether the application is for (A)
371		-	a new, additional, expanded or replacement facility, service or function
372		-	or relocation of facility beds, (B) a termination or reduction in a
373		-	presently authorized service or bed capacity, or (C) any new, additional
374		-	or terminated beds and their type; (3) the estimated capital cost; (4) the
375		-	town where the project is or will be located; and (5) a brief description
376		-	of the proposed project. Such request shall be deemed a letter of intent.
377		-	No certificate of need application shall be considered submitted to the
378		-	department unless a current letter of intent, specific to the proposal and
379		-	in accordance with the provisions of this subsection, has been on file Substitute Senate Bill No. 286
380		-
381		-	Public Act No. 22-145 12 of 19
382		-
383		-	with the department for not less than ten business days. For purposes of
384		-	this subsection, "a current letter of intent" means a letter of intent on file
385		-	with the department for not more than one hundred eighty days. A
386		-	certificate of need application shall be deemed withdrawn by the
387		-	department, if a department completeness letter is not responded to
388		-	within one hundred eighty days. The Office of the Long-Term Care
389		-	Ombudsman shall be notified by the facility at the same time as the letter
390		-	of intent is submitted to the department.
391		-	(e) Any facility acting pursuant to subdivision (3) of subsection (b) of
392		-	this section shall provide written notice, at the same time it submits its
393		-	letter of intent, to all patients, guardians or conservators, if any, or
394		-	legally liable relatives or other responsible parties, if known, and shall
395		-	post such notice in a conspicuous location at the facility. The facility's
396		-	written notice shall be accompanied by an informational letter issued
397		-	jointly from the Office of the Long-Term Care Ombudsman and the
398		-	Department of Aging and Disability Services on patients' rights and
399		-	services available as they relate to the letter of intent. The notice shall
400		-	state the following: (1) The projected date the facility will be submitting
401		-	its certificate of need application, (2) that only the Department of Social
402		-	Services has the authority to either grant, modify or deny the
403		-	application, (3) that the Department of Social Services has up to ninety
404		-	days to grant, modify or deny the certificate of need application, (4) a
405		-	brief description of the reason or reasons for submitting a request for
406		-	permission, (5) that no patient shall be involuntarily transferred or
407		-	discharged within or from a facility pursuant to state and federal law
408		-	because of the filing of the certificate of need application, (6) that all
409		-	patients have a right to appeal any proposed transfer or discharge, and
410		-	(7) the name, mailing address and telephone number of the Office of the
411		-	Long-Term Care Ombudsman and local legal aid office.
412		-	(f) The [department] Department of Social Services shall review a
413		-	request made pursuant to subsection (b) of this section to the extent it Substitute Senate Bill No. 286
414		-
415		-	Public Act No. 22-145 13 of 19
416		-
417		-	deems necessary, including, but not limited to, in the case of a proposed
418		-	transfer of ownership or control prior to initial licensure, the financial
419		-	responsibility and business interests of the transferee and the ability of
420		-	the facility to continue to provide needed services, or in the case of the
421		-	addition or expansion of a function or service, ascertaining the
422		-	availability of the function or service at other facilities within the area to
423		-	be served, the need for the service or function within the area and any
424		-	other factors the department deems relevant to a determination of
425		-	whether the facility is justified in adding or expanding the function or
426		-	service. During the review, the department may hold an informal
427		-	conference with the facility to discuss the certificate of need application.
428		-	The [commissioner] Commissioner of Social Services shall grant, modify
429		-	or deny the request within ninety days of receipt thereof, except as
430		-	otherwise provided in this section. The commissioner may place
431		-	conditions, as the commissioner deems necessary to address specified
432		-	concerns, on any decision approving or modifying a request for a
433		-	certificate of need filed pursuant to this section. Conditions may include,
434		-	but are not limited to, project and Medicaid reimbursement details and
435		-	applicant requirements for summary and audit purposes. If the
436		-	commissioner modifies the request, the commissioner shall notify the
437		-	facility of such modification prior to issuing the decision and provide
438		-	the applicant with an opportunity for an informal conference to discuss
439		-	the modifications. Upon the request of the applicant, the review period
440		-	may be extended for an additional fifteen days if the department has
441		-	requested additional information subsequent to the commencement of
442		-	the commissioner's review period. The director of the office of certificate
443		-	of need and rate setting may extend the review period for a maximum
444		-	of thirty days if the applicant has not filed in a timely manner
445		-	information deemed necessary by the department. The applicant may
446		-	request and shall receive a hearing in accordance with section 4-177 if
447		-	aggrieved by a decision of the commissioner.
448		-	(g) The Commissioner of Social Services shall not approve any Substitute Senate Bill No. 286
449		-
450		-	Public Act No. 22-145 14 of 19
451		-
452		-	requests for beds in residential facilities for persons with intellectual
453		-	disability which are licensed pursuant to section 17a-227 and are
454		-	certified to participate in the Title XIX Medicaid Program as
455		-	intermediate care facilities for individuals with intellectual disabilities,
456		-	except those beds necessary to implement the residential placement
457		-	goals of the Department of Developmental Services which are within
458		-	available appropriations.
459		-	(h) The Commissioner of Social Services shall adopt regulations, in
460		-	accordance with chapter 54, to implement the provisions of this section.
461		-	Sec. 7. Subsections (c) and (d) of section 17b-353 of the general statutes
462		-	are repealed and the following is substituted in lieu thereof (Effective July
463		-	1, 2022):
464		-	(c) In conducting its activities pursuant to this section, section 17b-
465		-	352, as amended by this act, or both, except as provided for in subsection
466		-	(d) of this section, the Commissioner of Social Services or said
467		-	commissioner's designee may hold a public hearing on an application
468		-	or on more than one application, if such applications are of a similar
469		-	nature with respect to the request. At least two weeks' notice of the
470		-	hearing shall be given to the facility by certified mail and to the public
471		-	by publication in a newspaper having a substantial circulation in the
472		-	area served by the facility. Such hearing shall be held at the discretion
473		-	of the commissioner in Hartford or in the area so served. Prior to the
474		-	hearing, the department may hold an informal conference with the
475		-	facility to discuss the certificate of need application. The commissioner
476		-	or the commissioner's designee shall consider such request in relation to
477		-	the community or regional need for such capital program or purchase
478		-	of land, the possible effect on the operating costs of the facility and such
479		-	other relevant factors as the commissioner or the commissioner's
480		-	designee deems necessary. In approving or modifying such request, the
481		-	commissioner or the commissioner's designee may not prescribe any
482		-	condition, such as, but not limited to, any condition or limitation on the Substitute Senate Bill No. 286
483		-
484		-	Public Act No. 22-145 15 of 19
485		-
486		-	indebtedness of the facility in connection with a bond issued, the
487		-	principal amount of any bond issued or any other details or particulars
488		-	related to the financing of such capital expenditure, not directly related
489		-	to the scope of such capital program and within the control of the
490		-	facility. If the hearing is conducted by a designee of the commissioner,
491		-	the designee shall submit any findings and recommendations to the
492		-	commissioner. If the designee recommends denial of the request, the
493		-	designee shall issue a proposed final decision in accordance with section
494		-	4-179. The commissioner shall grant, modify or deny such request
495		-	within ninety days, except as provided for in this section. The
496		-	commissioner may place conditions, as the commissioner deems
497		-	necessary to address specified concerns, on any decision approving or
498		-	modifying a request for a certificate of need filed pursuant to this
499		-	section. Conditions may include, but are not limited to, project and
500		-	Medicaid reimbursement details and applicant requirements for
501		-	summary and audit purposes. Upon the request of the applicant, the
502		-	review period may be extended for an additional fifteen days if the
503		-	commissioner or the commissioner's designee has requested additional
504		-	information subsequent to the commencement of the review period. The
505		-	commissioner or the commissioner's designee may extend the review
506		-	period for a maximum of thirty days if the applicant has not filed in a
507		-	timely manner information deemed necessary by the commissioner or
508		-	the commissioner's designee.
509		-	(d) Except as provided in this subsection, no facility shall be allowed
510		-	to close or decrease substantially its licensed total bed capacity until
511		-	such time as a public hearing has been held in accordance with the
512		-	provisions of this subsection and the Commissioner of Social Services
513		-	has approved the facility's request unless such decrease is associated
514		-	with a census reduction. The commissioner may impose a civil penalty
515		-	of not more than five thousand dollars on any facility that fails to
516		-	comply with the provisions of this subsection. Penalty payments
517		-	received by the commissioner pursuant to this subsection shall be Substitute Senate Bill No. 286
518		-
519		-	Public Act No. 22-145 16 of 19
520		-
521		-	deposited in the special fund established by the department pursuant to
522		-	subsection (c) of section 17b-357 and used for the purposes specified in
523		-	said subsection (c). The commissioner or the commissioner's designee
524		-	shall hold a public hearing [upon the earliest occurrence of: (1) Receipt
525		-	of any letter of intent submitted by a facility to the department, or (2)]
526		-	not later than thirty days after the receipt of any certificate of need
527		-	application. Such hearing shall be held at the facility for which the [letter
528		-	of intent or] certificate of need application was submitted. [not later than
529		-	thirty days after the date on which such letter or application was
530		-	received by the commissioner.] The commissioner or the
531		-	commissioner's designee shall provide both the facility and the public
532		-	with notice of the date of the hearing not less than [fourteen] ten days in
533		-	advance of such date. Notice to the facility shall be [by certified mail]
534		-	sent via electronic mail or first-class mail and notice to the public shall
535		-	be by publication in a newspaper having a substantial circulation in the
536		-	area served by the facility. The provisions of this subsection shall not
537		-	apply to any certificate of need approval requested for the relocation of
538		-	a facility, or a portion of a facility's licensed beds, to a new or
539		-	replacement facility.
540		-	Sec. 8. Subsection (a) of section 17b-354 of the general statutes is
541		-	repealed and the following is substituted in lieu thereof (Effective July 1,
542		-	2022):
543		-	(a) The Department of Social Services shall not accept or approve any
544		-	requests for additional nursing home beds, except (1) beds restricted to
545		-	use by patients with acquired immune deficiency syndrome or by
546		-	patients requiring neurological rehabilitation; (2) beds associated with a
547		-	continuing care facility, as described in section 17b-520, provided such
548		-	beds are not used in the Medicaid program. [and the ratio of proposed
549		-	nursing home beds to the continuing care facility's independent living
550		-	units is within applicable industry standards.] For the purpose of this
551		-	subsection, beds associated with a continuing care facility are not subject Substitute Senate Bill No. 286
552		-
553		-	Public Act No. 22-145 17 of 19
554		-
555		-	to the certificate of need provisions pursuant to sections 17b-352, as
556		-	amended by this act, and 17b-353, as amended by this act; (3) Medicaid
557		-	certified beds to be relocated from one licensed nursing facility to
558		-	another licensed nursing facility to meet a priority need identified in the
559		-	strategic plan developed pursuant to subsection (c) of section 17b-369;
560		-	[and] (4) licensed Medicaid nursing facility beds to be relocated from
561		-	one or more existing nursing facilities to a new nursing facility,
562		-	including a replacement facility, provided (A) no new Medicaid
563		-	certified beds are added, (B) at least one currently licensed facility is
564		-	closed in the transaction as a result of the relocation, (C) the relocation
565		-	is done within available appropriations, (D) the facility participates in
566		-	the Money Follows the Person demonstration project pursuant to
567		-	section 17b-369, (E) the availability of beds in the area of need will not
568		-	be adversely affected, (F) the certificate of need approval for such new
569		-	facility or facility relocation and the associated capital expenditures are
570		-	obtained pursuant to sections 17b-352, as amended by this act, and 17b-
571		-	353, as amended by this act, and (G) the facilities included in the bed
572		-	relocation and closure shall be in accordance with the strategic plan
573		-	developed pursuant to subsection (c) of section 17b-369; and (5)
574		-	proposals to build a nontraditional, small-house style nursing home
575		-	designed to enhance the quality of life for nursing facility residents,
576		-	provided that the nursing facility agrees to reduce its total number of
577		-	licensed beds by a percentage determined by the Commissioner of
578		-	Social Services in accordance with the department's strategic plan for
579		-	long-term care.
580		-	Sec. 9. Section 17b-355 of the general statutes is repealed and the
581		-	following is substituted in lieu thereof (Effective July 1, 2022):
582		-	In determining whether a request submitted pursuant to sections
583		-	17b-352 to 17b-354, inclusive, as amended by this act, will be granted,
584		-	modified or denied, the Commissioner of Social Services shall consider
585		-	the following: The [relationship of the request to the state health plan, Substitute Senate Bill No. 286
586		-
587		-	Public Act No. 22-145 18 of 19
588		-
589		-	the] financial feasibility of the request and its impact on the applicant's
590		-	rates and financial condition, the contribution of the request to the
591		-	quality, accessibility and cost-effectiveness of [health care delivery] the
592		-	delivery of long-term care in the region, whether there is clear public
593		-	need for the request, the relationship of any proposed change to the
594		-	applicant's current utilization statistics and the effect of the proposal on
595		-	the utilization statistics of other facilities in the applicant's service area,
596		-	the business interests of all owners, partners, associates, incorporators,
597		-	directors, sponsors, stockholders and operators and the personal
598		-	background of such persons, and any other factor which the
599		-	[department] Department of Social Services deems relevant. [Whenever
600		-	the granting, modification or denial of a request is inconsistent with the
601		-	state health plan, a written explanation of the reasons for the
602		-	inconsistency shall be included in the decision. In considering whether
603		-	there is clear public need for any request for additional nursing home
604		-	beds associated with a continuing care facility submitted pursuant to
605		-	section 17b-354, the commissioner shall only consider the need for beds
606		-	for current and prospective residents of the continuing care facility.] In
607		-	considering whether there is clear public need for any request for the
608		-	relocation of beds to a replacement facility, the commissioner shall
609		-	consider whether there is a demonstrated bed need in the towns within
610		-	a fifteen-mile radius of the town in which the beds are proposed to be
611		-	located and whether the availability of beds in the applicant's service
612		-	area will be adversely affected. Any proposal to relocate nursing home
613		-	beds from an existing facility to a new facility shall not increase the
614		-	number of Medicaid certified beds and shall result in the closure of at
615		-	least one currently licensed facility. The commissioner may request that
616		-	any applicant seeking to replace an existing facility reduce the number
617		-	of beds in the new facility by a percentage that is consistent with the
618		-	department's strategic plan for long-term care. If an applicant seeking to
619		-	replace an existing facility with a new facility owns or operates more
620		-	than one nursing facility, the commissioner may request that the
621		-	applicant close two or more facilities before approving the proposal to Substitute Senate Bill No. 286
622		-
623		-	Public Act No. 22-145 19 of 19
624		-
625		-	build a new facility. The commissioner shall also consider whether an
626		-	application to establish a new or replacement nursing facility proposes
627		-	a nontraditional, small-house style nursing facility and incorporates
628		-	goals for nursing facilities referenced in the department's strategic plan
629		-	for long-term care, including, but not limited to, (1) promoting person-
630		-	centered care, (2) providing enhanced quality of care, (3) creating
631		-	community space for all nursing facility residents, and (4) developing
632		-	stronger connections between the nursing facility residents and the
633		-	surrounding community. Bed need shall be based on the recent
634		-	occupancy percentage of area nursing facilities and the projected bed
635		-	need for no more than five years into the future at ninety-seven and one-
636		-	half per cent occupancy using the latest official population projections
637		-	by town and age as published by the Office of Policy and Management
638		-	and the latest available state-wide nursing facility utilization statistics
639		-	by age cohort from the Department of Public Health. The commissioner
640		-	may also consider area specific utilization and reductions in utilization
641		-	rates to account for the increased use of less institutional alternatives.
642	99