Connecticut 2022 Regular Session

Connecticut Senate Bill SB00290 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 290
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	8	+	General Assembly Raised Bill No. 290
8	9		February Session, 2022
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	13	+	Referred to Committee on HUMAN SERVICES
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	16	+	Introduced by:
	17	+	(HS)
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14	22		AN ACT CONCERNING CERTIFICATES OF NEED FOR LONG -TERM
15	23		CARE FACILITIES.
16	24		Be it enacted by the Senate and House of Representatives in General
17	25		Assembly convened:
18	26
19	27		Section 1. Section 17b-352 of the general statutes is repealed and the 1
20	28		following is substituted in lieu thereof (Effective July 1, 2022): 2
21	29		(a) For the purposes of this section and section 17b-353, as amended 3
22	30		by this act, "facility" means a residential facility for persons with 4
23	31		intellectual disability licensed pursuant to section 17a-277 and certified 5
24	32		to participate in the Title XIX Medicaid program as an intermediate care 6
25	33		facility for individuals with intellectual disabilities, a nursing home, rest 7
26	34		home or residential care home, as defined in section 19a-490. "Facility" 8
27	35		does not include a nursing home that does not participate in the 9
28	36		Medicaid program and is associated with a continuing care facility as 10
29	37		described in section 17b-520. 11
30	38		(b) Any facility which intends to (1) transfer all or part of its 12
31	39		ownership or control prior to being initially licensed; (2) introduce any 13
32	40		additional function or service into its program of care or expand an 14
33		-	existing function or service; (3) terminate a service or decrease 15
34		-	substantially its total licensed bed capacity; or (4) relocate all or a portion 16
35		-	of such facility's licensed beds, to a new facility or replacement facility, 17
36		-	shall submit a complete request for permission to implement such 18 Substitute Bill No. 290
	41	+	existing function or service; (3) terminate a service or decrease 15 Raised Bill No. 290
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43		-	transfer, addition, expansion, increase, termination, decrease or 19
44		-	relocation of facility beds to the Department of Social Services with such 20
45		-	information as the department requires, provided no permission or 21
46		-	request for permission to close a facility is required when a facility in 22
47		-	receivership is closed by order of the Superior Court pursuant to section 23
48		-	19a-545. The Commissioner of Social Services shall consider the criteria 24
49		-	in subdivisions (3) and (4) of subsection (a) of section 17b-354, as 25
50		-	amended by this act, when evaluating a certificate of need request to 26
51		-	relocate licensed nursing facility beds from an existing facility to another 27
52		-	licensed nursing facility or to a new facility or replacement facility. The 28
53		-	Office of the Long-Term Care Ombudsman pursuant to section 17a-405 29
54		-	shall be notified by the facility of any proposed actions pursuant to this 30
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	47	+	substantially its total bed capacity; or (4) relocate all or a portion of such 16
	48	+	facility's licensed beds, to a new facility or replacement facility, shall 17
	49	+	submit a complete request for permission to implement such transfer, 18
	50	+	addition, expansion, increase, termination, decrease or relocation of 19
	51	+	facility beds to the Department of Social Services with such information 20
	52	+	as the department requires, provided no permission or request for 21
	53	+	permission to close a facility is required when a facility in receivership 22
	54	+	is closed by order of the Superior Court pursuant to section 19a-545. The 23
	55	+	Commissioner of Social Services shall consider the criteria in 24
	56	+	subdivisions (3) and (4) of subsection (a) of section 17b-354, as amended 25
	57	+	by this act, when evaluating a certificate of need request to relocate 26
	58	+	nursing facility beds from an existing facility to another licensed nursing 27
	59	+	facility or to a new facility or replacement facility. The Office of the 28
	60	+	Long-Term Care Ombudsman pursuant to section 17a-405 shall be 29
	61	+	notified by the facility of any proposed actions pursuant to this 30
55	62		subsection at the same time the request for permission is submitted to 31
56	63		the department and when a facility in receivership is closed by order of 32
57	64		the Superior Court pursuant to section 19a-545. 33
58	65		(c) A facility may submit a petition for closure to the Department of 34
59	66		Social Services. The Department of Social Services may authorize the 35
60	67		closure of a facility if the facility's management demonstrates to the 36
61	68		satisfaction of the Commissioner of Social Services in the petition for 37
62	69		closure that the facility (1) is not viable based on actual and projected 38
63	70		operating losses; (2) has an occupancy rate of less than seventy per cent 39
64	71		of the facility's licensed bed capacity; (3) closure is consistent with the 40
65	72		strategic rebalancing plan developed in accordance with section 17b-41
66	73		369, including bed need by geographical region; (4) is in compliance 42
67	74		with the requirements of Sections 1128I(h) and 1819(h)(4) of the Social 43
68	75		Security Act and 42 CFR 483.75; and (5) is not providing special services 44
69	76		that would go unmet if the facility closes. The department shall review 45
70	77		a petition for closure to the extent it deems necessary and the facility 46
71	78		shall submit information the department requests or deems necessary 47
72	79		to substantiate that the facility closure is consistent with the provisions 48
73		-	of this subsection. The facility shall submit information the department 49
	80	+	of this subsection. The facility shall submit information the department 49 Raised Bill No. 290
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74	86		requests or deems necessary to allow the department to provide 50
75	87		oversight during this process. The Office of the Long-Term Care 51
76		-	Ombudsman shall be notified by the facility at the same time as a 52 Substitute Bill No. 290
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	88	+	Ombudsman shall be notified by the facility at the same time as a 52
83	89		petition for closure is submitted to the department. Any facility acting 53
84	90		pursuant to this subsection shall provide written notice, on the same 54
85	91		date that the facility submits its petition for closure, to all patients, 55
86	92		guardians or conservators, if any, or legally liable relatives or other 56
87	93		responsible parties, if known, and shall post such notice in a 57
88	94		conspicuous location at the facility. The facility's written notice shall be 58
89	95		accompanied by an informational letter issued jointly from the Office of 59
90	96		the Long-Term Care Ombudsman and the Department of Rehabilitation 60
91	97		Services on patients' rights and services available as they relate to the 61
92	98		petition for closure. The informational letter shall also state the date and 62
93	99		time that the Office of the Long-Term Care Ombudsman and the 63
94	100		Department of Public Health will hold an informational session at the 64
95	101		facility for patients, guardians or conservators, if any, and legally liable 65
96	102		relatives or other responsible parties, if known, about their rights and 66
97	103		the process concerning a petition for closure. The notice shall state: (A) 67
98	104		The date the facility submitted the petition for closure, (B) that only the 68
99	105		Department of Social Services has the authority to either grant or deny 69
100	106		the petition for closure, (C) that the Department of Social Services has 70
101	107		up to thirty days to grant or deny the petition for closure, (D) a brief 71
102	108		description of the reason or reasons for submitting the petition for 72
103	109		closure, (E) that no patient shall be involuntarily transferred or 73
104	110		discharged within or from a facility pursuant to state and federal law 74
105	111		because of the filing of a petition for closure, (F) that all patients have a 75
106	112		right to appeal any proposed transfer or discharge, and (G) the name, 76
107	113		mailing address and telephone number of the Office of the Long-Term 77
108	114		Care Ombudsman and local legal aid office. The commissioner shall 78
109	115		grant or deny a petition for closure within thirty days of receiving such 79
110	116		request. 80
111	117		(d) An applicant, prior to submitting a certificate of need application, 81
112	118		shall request, in writing, application forms and instructions from the 82
113		-	department. The request shall include: (1) The name of the applicant or 83
	119	+	department. The request shall include: (1) The name of the applicant or 83 Raised Bill No. 290
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114	125		applicants; (2) a statement indicating whether the application is for (A) 84
115	126		a new, additional, expanded or replacement facility, service or function 85
116		-	or relocation of facility beds, (B) a termination or reduction in a 86 Substitute Bill No. 290
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	127	+	or relocation of facility beds, (B) a termination or reduction in a 86
123	128		presently authorized service or bed capacity, or (C) any new, additional 87
124	129		or terminated beds and their type; (3) the estimated capital cost; (4) the 88
125	130		town where the project is or will be located; and (5) a brief description 89
126	131		of the proposed project. Such request shall be deemed a letter of intent. 90
127	132		No certificate of need application shall be considered submitted to the 91
128	133		department unless a current letter of intent, specific to the proposal and 92
129	134		in accordance with the provisions of this subsection, has been on file 93
130	135		with the department for not less than ten business days. For purposes of 94
131	136		this subsection, "a current letter of intent" means a letter of intent on file 95
132	137		with the department for not more than one hundred eighty days. A 96
133	138		certificate of need application shall be deemed withdrawn by the 97
134	139		department, if a department completeness letter is not responded to 98
135	140		within one hundred eighty days. The Office of the Long-Term Care 99
136	141		Ombudsman shall be notified by the facility at the same time as the letter 100
137	142		of intent is submitted to the department. 101
138	143		(e) Any facility acting pursuant to subdivision (3) of subsection (b) of 102
139	144		this section shall provide written notice, at the same time it submits its 103
140	145		letter of intent, to all patients, guardians or conservators, if any, or 104
141	146		legally liable relatives or other responsible parties, if known, and shall 105
142	147		post such notice in a conspicuous location at the facility. The facility's 106
143	148		written notice shall be accompanied by an informational letter issued 107
144	149		jointly from the Office of the Long-Term Care Ombudsman and the 108
145	150		Department of Aging and Disability Services on patients' rights and 109
146	151		services available as they relate to the letter of intent. The notice shall 110
147	152		state the following: (1) The projected date the facility will be submitting 111
148	153		its certificate of need application, (2) that only the Department of Social 112
149	154		Services has the authority to either grant, modify or deny the 113
150	155		application, (3) that the Department of Social Services has up to ninety 114
151	156		days to grant, modify or deny the certificate of need application, (4) a 115
152	157		brief description of the reason or reasons for submitting a request for 116
153		-	permission, (5) that no patient shall be involuntarily transferred or 117
	158	+	permission, (5) that no patient shall be involuntarily transferred or 117 Raised Bill No. 290
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154	164		discharged within or from a facility pursuant to state and federal law 118
155	165		because of the filing of the certificate of need application, (6) that all 119
156		-	patients have a right to appeal any proposed transfer or discharge, and 120 Substitute Bill No. 290
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	166	+	patients have a right to appeal any proposed transfer or discharge, and 120
163	167		(7) the name, mailing address and telephone number of the Office of the 121
164	168		Long-Term Care Ombudsman and local legal aid office. 122
165	169		(f) The [department] Department of Social Services shall review a 123
166	170		request made pursuant to subsection (b) of this section to the extent it 124
167	171		deems necessary, including, but not limited to, in the case of a proposed 125
168	172		transfer of ownership or control prior to initial licensure, the financial 126
169	173		responsibility and business interests of the transferee and the ability of 127
170	174		the facility to continue to provide needed services, or in the case of the 128
171	175		addition or expansion of a function or service, ascertaining the 129
172	176		availability of the function or service at other facilities within the area to 130
173	177		be served, the need for the service or function within the area and any 131
174	178		other factors the department deems relevant to a determination of 132
175	179		whether the facility is justified in adding or expanding the function or 133
176		-	service. During the review, the department may hold an informal 134
177		-	conference with the facility to discuss the certificate of need application. 135
178		-	The [commissioner] Commissioner of Social Services shall grant, modify 136
179		-	or deny the request within ninety days of receipt thereof, except as 137
180		-	otherwise provided in this section. The commissioner may place 138
181		-	conditions, as the commissioner deems necessary to address specified 139
182		-	concerns, on any decision approving or modifying a request for a 140
183		-	certificate of need filed pursuant to this section. Conditions may include, 141
184		-	but are not limited to, project and Medicaid reimbursement details and 142
185		-	applicant requirements for summary and audit purposes. If the 143
186		-	commissioner modifies the request, the commissioner shall notify the 144
187		-	facility of such modification prior to issuing the decision and provide 145
188		-	the applicant with an opportunity for an informal conference to discuss 146
189		-	the modifications. Upon the request of the applicant, the review period 147
190		-	may be extended for an additional fifteen days if the department has 148
191		-	requested additional information subsequent to the commencement of 149
192		-	the commissioner's review period. The director of the office of certificate 150
193		-	of need and rate setting may extend the review period for a maximum 151
194		-	of thirty days if the applicant has not filed in a timely manner 152
195		-	information deemed necessary by the department. The applicant may 153
196		-	request and shall receive a hearing in accordance with section 4-177 if 154 Substitute Bill No. 290
	180	+	service. The [commissioner] Commissioner of Social Services shall 134
	181	+	grant, modify or deny the request within ninety days of receipt thereof, 135
	182	+	except as otherwise provided in this section. The commissioner may 136
	183	+	place conditions, as the commissioner deems necessary to address 137
	184	+	specified concerns, on any decision approving or modifying a request 138
	185	+	for a certificate of need filed pursuant to this section. Conditions may 139
	186	+	include, but are not limited to, project and Medicaid reimbursement 140
	187	+	details and applicant requirements for summary and audit purposes. 141
	188	+	Upon the request of the applicant, the review period may be extended 142
	189	+	for an additional fifteen days if the department has requested additional 143
	190	+	information subsequent to the commencement of the commissioner's 144
	191	+	review period. The director of the office of certificate of need and rate 145
	192	+	setting may extend the review period for a maximum of thirty days if 146
	193	+	the applicant has not filed in a timely manner information deemed 147
	194	+	necessary by the department. The applicant may request and shall 148
	195	+	receive a hearing in accordance with section 4-177 if aggrieved by a 149
	196	+	decision of the commissioner. 150
	197	+	(g) The Commissioner of Social Services shall not approve any 151 Raised Bill No. 290
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203		-	aggrieved by a decision of the commissioner. 155
204		-	(g) The Commissioner of Social Services shall not approve any 156
205		-	requests for beds in residential facilities for persons with intellectual 157
206		-	disability which are licensed pursuant to section 17a-227 and are 158
207		-	certified to participate in the Title XIX Medicaid Program as 159
208		-	intermediate care facilities for individuals with intellectual disabilities, 160
209		-	except those beds necessary to implement the residential placement 161
210		-	goals of the Department of Developmental Services which are within 162
211		-	available appropriations. 163
212		-	(h) The Commissioner of Social Services shall adopt regulations, in 164
213		-	accordance with chapter 54, to implement the provisions of this section. 165
214		-	Sec. 2. Subsections (c) and (d) of section 17b-353 of the general statutes 166
215		-	are repealed and the following is substituted in lieu thereof (Effective July 167
216		-	1, 2022): 168
217		-	(c) In conducting its activities pursuant to this section, section 17b-169
218		-	352, as amended by this act, or both, except as provided for in subsection 170
219		-	(d) of this section, the Commissioner of Social Services or said 171
220		-	commissioner's designee may hold a public hearing on an application 172
221		-	or on more than one application, if such applications are of a similar 173
222		-	nature with respect to the request. At least two weeks' notice of the 174
223		-	hearing shall be given to the facility by certified mail and to the public 175
224		-	by publication in a newspaper having a substantial circulation in the 176
225		-	area served by the facility. Such hearing shall be held at the discretion 177
226		-	of the commissioner in Hartford or in the area so served. Prior to the 178
227		-	hearing, the department may hold an informal conference with the 179
228		-	facility to discuss the certificate of need application. The commissioner 180
229		-	or the commissioner's designee shall consider such request in relation to 181
230		-	the community or regional need for such capital program or purchase 182
231		-	of land, the possible effect on the operating costs of the facility and such 183
232		-	other relevant factors as the commissioner or the commissioner's 184
233		-	designee deems necessary. In approving or modifying such request, the 185
234		-	commissioner or the commissioner's designee may not prescribe any 186 Substitute Bill No. 290
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	203	+	requests for beds in residential facilities for persons with intellectual 152
	204	+	disability which are licensed pursuant to section 17a-227 and are 153
	205	+	certified to participate in the Title XIX Medicaid Program as 154
	206	+	intermediate care facilities for individuals with intellectual disabilities, 155
	207	+	except those beds necessary to implement the residential placement 156
	208	+	goals of the Department of Developmental Services which are within 157
	209	+	available appropriations. 158
	210	+	(h) The Commissioner of Social Services shall adopt regulations, in 159
	211	+	accordance with chapter 54, to implement the provisions of this section. 160
	212	+	Sec. 2. Subsection (c) of section 17b-353 of the general statutes is 161
	213	+	repealed and the following is substituted in lieu thereof (Effective July 1, 162
	214	+	2022): 163
	215	+	(c) In conducting its activities pursuant to this section, section 17b-164
	216	+	352, as amended by this act, or both, except as provided for in subsection 165
	217	+	(d) of this section, the Commissioner of Social Services or said 166
	218	+	commissioner's designee may hold a public hearing on an application 167
	219	+	or on more than one application, if such applications are of a similar 168
	220	+	nature with respect to the request. At least two weeks' notice of the 169
	221	+	hearing shall be given to the facility by certified mail and to the public 170
	222	+	by publication in a newspaper having a substantial circulation in the 171
	223	+	area served by the facility. Such hearing shall be held at the discretion 172
	224	+	of the commissioner in Hartford or in the area so served. The 173
	225	+	commissioner or the commissioner's designee shall consider such 174
	226	+	request in relation to the community or regional need for such capital 175
	227	+	program or purchase of land, the possible effect on the operating costs 176
	228	+	of the facility and such other relevant factors as the commissioner or the 177
	229	+	commissioner's designee deems necessary. In approving or modifying 178
	230	+	such request, the commissioner or the commissioner's designee may not 179
	231	+	prescribe any condition, such as, but not limited to, any condition or 180
	232	+	limitation on the indebtedness of the facility in connection with a bond 181
	233	+	issued, the principal amount of any bond issued or any other details or 182
	234	+	particulars related to the financing of such capital expenditure, not 183
	235	+	directly related to the scope of such capital program and within the 184 Raised Bill No. 290
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241		-	condition, such as, but not limited to, any condition or limitation on the 187
242		-	indebtedness of the facility in connection with a bond issued, the 188
243		-	principal amount of any bond issued or any other details or particulars 189
244		-	related to the financing of such capital expenditure, not directly related 190
245		-	to the scope of such capital program and within the control of the 191
246		-	facility. If the hearing is conducted by a designee of the commissioner, 192
247		-	the designee shall submit any findings and recommendations to the 193
248		-	commissioner. If the designee recommends denial of the request, the 194
249		-	designee shall issue a proposed final decision in accordance with section 195
250		-	4-179. The commissioner shall grant, modify or deny such request 196
251		-	within ninety days, except as provided for in this section. The 197
252		-	commissioner may place conditions, as the commissioner deems 198
253		-	necessary to address specified concerns, on any decision approving or 199
254		-	modifying a request for a certificate of need filed pursuant to this 200
255		-	section. Conditions may include, but are not limited to, project and 201
256		-	Medicaid reimbursement details and applicant requirements for 202
257		-	summary and audit purposes. Upon the request of the applicant, the 203
258		-	review period may be extended for an additional fifteen days if the 204
259		-	commissioner or the commissioner's designee has requested additional 205
260		-	information subsequent to the commencement of the review period. The 206
261		-	commissioner or the commissioner's designee may extend the review 207
262		-	period for a maximum of thirty days if the applicant has not filed in a 208
263		-	timely manner information deemed necessary by the commissioner or 209
264		-	the commissioner's designee. 210
265		-	(d) Except as provided in this subsection, no facility shall be allowed 211
266		-	to close or decrease substantially its licensed total bed capacity until 212
267		-	such time as a public hearing has been held in accordance with the 213
268		-	provisions of this subsection and the Commissioner of Social Services 214
269		-	has approved the facility's request unless such decrease is associated 215
270		-	with a census reduction. The commissioner may impose a civil penalty 216
271		-	of not more than five thousand dollars on any facility that fails to 217
272		-	comply with the provisions of this subsection. Penalty payments 218
273		-	received by the commissioner pursuant to this subsection shall be 219
274		-	deposited in the special fund established by the department pursuant to 220 Substitute Bill No. 290
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	241	+	control of the facility. If the hearing is conducted by a designee of the 185
	242	+	commissioner, the designee shall submit any findings and 186
	243	+	recommendations to the commissioner. The commissioner shall grant, 187
	244	+	modify or deny such request within ninety days, except as provided for 188
	245	+	in this section. The commissioner may place conditions, as the 189
	246	+	commissioner deems necessary to address specified concerns, on any 190
	247	+	decision approving or modifying a request for a certificate of need filed 191
	248	+	pursuant to this section. Conditions may include, but are not limited to, 192
	249	+	project and Medicaid reimbursem ent details and applicant 193
	250	+	requirements for summary and audit purposes. Upon the request of the 194
	251	+	applicant, the review period may be extended for an additional fifteen 195
	252	+	days if the commissioner or the commissioner's designee has requested 196
	253	+	additional information subsequent to the commencement of the review 197
	254	+	period. The commissioner or the commissioner's designee may extend 198
	255	+	the review period for a maximum of thirty days if the applicant has not 199
	256	+	filed in a timely manner information deemed necessary by the 200
	257	+	commissioner or the commissioner's designee. 201
	258	+	Sec. 3. Subsection (a) of section 17b-354 of the general statutes is 202
	259	+	repealed and the following is substituted in lieu thereof (Effective July 1, 203
	260	+	2022): 204
	261	+	(a) The Department of Social Services shall not accept or approve any 205
	262	+	requests for additional nursing home beds, except (1) beds restricted to 206
	263	+	use by patients with acquired immune deficiency syndrome or by 207
	264	+	patients requiring neurological rehabilitation; (2) beds associated with a 208
	265	+	continuing care facility, as described in section 17b-520, provided such 209
	266	+	beds are not used in the Medicaid program and the ratio of proposed 210
	267	+	nursing home beds to the continuing care facility's independent living 211
	268	+	units is within applicable industry standards. For the purpose of this 212
	269	+	subsection, beds associated with a continuing care facility are not subject 213
	270	+	to the certificate of need provisions pursuant to sections 17b-352, as 214
	271	+	amended by this act, and 17b-353, as amended by this act; (3) Medicaid 215
	272	+	certified beds to be relocated from one licensed nursing facility to 216
	273	+	another licensed nursing facility to meet a priority need identified in the 217
	274	+	strategic plan developed pursuant to subsection (c) of section 17b-369; 218 Raised Bill No. 290
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281		-	subsection (c) of section 17b-357 and used for the purposes specified in 221
282		-	said subsection (c). The commissioner or the commissioner's designee 222
283		-	shall hold a public hearing [upon the earliest occurrence of: (1) Receipt 223
284		-	of any letter of intent submitted by a facility to the department, or (2)] 224
285		-	not later than thirty days after the receipt of any certificate of need 225
286		-	application. Such hearing shall be held at the facility for which the [letter 226
287		-	of intent or] certificate of need application was submitted. [not later than 227
288		-	thirty days after the date on which such letter or application was 228
289		-	received by the commissioner.] The commissioner or the 229
290		-	commissioner's designee shall provide both the facility and the public 230
291		-	with notice of the date of the hearing not less than [fourteen] ten days in 231
292		-	advance of such date. Notice to the facility shall be [by certified mail] 232
293		-	sent via electronic mail or first-class mail and notice to the public shall 233
294		-	be by publication in a newspaper having a substantial circulation in the 234
295		-	area served by the facility. The provisions of this subsection shall not 235
296		-	apply to any certificate of need approval requested for the relocation of 236
297		-	a facility, or a portion of a facility's licensed beds, to a new or 237
298		-	replacement facility. 238
299		-	Sec. 3. Subsection (a) of section 17b-354 of the general statutes is 239
300		-	repealed and the following is substituted in lieu thereof (Effective July 1, 240
301		-	2022): 241
302		-	(a) The Department of Social Services shall not accept or approve any 242
303		-	requests for additional nursing home beds, except (1) beds restricted to 243
304		-	use by patients with acquired immune deficiency syndrome or by 244
305		-	patients requiring neurological rehabilitation; (2) beds associated with a 245
306		-	continuing care facility, as described in section 17b-520, provided such 246
307		-	beds are not used in the Medicaid program. [and the ratio of proposed 247
308		-	nursing home beds to the continuing care facility's independent living 248
309		-	units is within applicable industry standards.] For the purpose of this 249
310		-	subsection, beds associated with a continuing care facility are not subject 250
311		-	to the certificate of need provisions pursuant to sections 17b-352, as 251
312		-	amended by this act, and 17b-353, as amended by this act; (3) Medicaid 252
313		-	certified beds to be relocated from one licensed nursing facility to 253 Substitute Bill No. 290
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	280	+	[and] (4) licensed Medicaid nursing facility beds to be relocated from 219
	281	+	one or more existing nursing facilities to a new nursing facility, 220
	282	+	provided (A) no new Medicaid certified beds are added, (B) at least one 221
	283	+	currently licensed facility is closed in the transaction as a result of the 222
	284	+	relocation, (C) the relocation is done within available appropriations, 223
	285	+	(D) the facility participates in the Money Follows the Person 224
	286	+	demonstration project pursuant to section 17b-369, (E) the availability of 225
	287	+	beds in the area of need will not be adversely affected, (F) the certificate 226
	288	+	of need approval for such new facility or facility relocation and the 227
	289	+	associated capital expenditures are obtained pursuant to sections 17b-228
	290	+	352, as amended by this act, and 17b-353, as amended by this act, and 229
	291	+	(G) the facilities included in the bed relocation and closure shall be in 230
	292	+	accordance with the strategic plan developed pursuant to subsection (c) 231
	293	+	of section 17b-369; and (5) proposals to build a nontraditional, small-232
	294	+	house style nursing home designed to enhance the quality of life for 233
	295	+	nursing facility residents, provided that the nursing facility agrees to 234
	296	+	reduce its total number of licensed beds by a percentage determined by 235
	297	+	the Commissioner of Social Services in accordance with the 236
	298	+	department's strategic plan for long-term care. 237
	299	+	Sec. 4. Section 17b-355 of the general statutes is repealed and the 238
	300	+	following is substituted in lieu thereof (Effective July 1, 2022): 239
	301	+	In determining whether a request submitted pursuant to sections 17b-240
	302	+	352 to 17b-354, inclusive, as amended by this act, will be granted, 241
	303	+	modified or denied, the Commissioner of Social Services shall consider 242
	304	+	the following: The [relationship of the request to the state health plan, 243
	305	+	the] financial feasibility of the request and its impact on the applicant's 244
	306	+	rates and financial condition, the contribution of the request to the 245
	307	+	quality, accessibility and cost-effectiveness of [health care delivery] the 246
	308	+	delivery of long-term care in the region, whether there is clear public 247
	309	+	need for the request, the relationship of any proposed change to the 248
	310	+	applicant's current utilization statistics and the effect of the proposal on 249
	311	+	the utilization statistics of other facilities in the applicant's service area, 250
	312	+	the business interests of all owners, partners, associates, incorporators, 251
	313	+	directors, sponsors, stockholders and operators and the personal 252 Raised Bill No. 290
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319	316
320		-	another licensed nursing facility to meet a priority need identified in the 254
321		-	strategic plan developed pursuant to subsection (c) of section 17b-369; 255
322		-	[and] (4) licensed Medicaid nursing facility beds to be relocated from 256
323		-	one or more existing nursing facilities to a new nursing facility, 257
324		-	including a replacement facility, provided (A) no new Medicaid 258
325		-	certified beds are added, (B) at least one currently licensed facility is 259
326		-	closed in the transaction as a result of the relocation, (C) the relocation 260
327		-	is done within available appropriations, (D) the facility participates in 261
328		-	the Money Follows the Person demonstration project pursuant to 262
329		-	section 17b-369, (E) the availability of beds in the area of need will not 263
330		-	be adversely affected, (F) the certificate of need approval for such new 264
331		-	facility or facility relocation and the associated capital expenditures are 265
332		-	obtained pursuant to sections 17b-352, as amended by this act, and 17b-266
333		-	353, as amended by this act, and (G) the facilities included in the bed 267
334		-	relocation and closure shall be in accordance with the strategic plan 268
335		-	developed pursuant to subsection (c) of section 17b-369; and (5) 269
336		-	proposals to build a nontraditional, small-house style nursing home 270
337		-	designed to enhance the quality of life for nursing facility residents, 271
338		-	provided that the nursing facility agrees to reduce its total number of 272
339		-	licensed beds by a percentage determined by the Commissioner of 273
340		-	Social Services in accordance with the department's strategic plan for 274
341		-	long-term care. 275
342		-	Sec. 4. Section 17b-355 of the general statutes is repealed and the 276
343		-	following is substituted in lieu thereof (Effective July 1, 2022): 277
344		-	In determining whether a request submitted pursuant to sections 278
345		-	17b-352 to 17b-354, inclusive, as amended by this act, will be granted, 279
346		-	modified or denied, the Commissioner of Social Services shall consider 280
347		-	the following: The [relationship of the request to the state health plan, 281
348		-	the] financial feasibility of the request and its impact on the applicant's 282
349		-	rates and financial condition, the contribution of the request to the 283
350		-	quality, accessibility and cost-effectiveness of [health care delivery] the 284
351		-	delivery of long-term care in the region, whether there is clear public 285
352		-	need for the request, the relationship of any proposed change to the 286 Substitute Bill No. 290
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	318	+
	319	+	background of such persons, and any other factor which the 253
	320	+	[department] Department of Social Services deems relevant. [Whenever 254
	321	+	the granting, modification or denial of a request is inconsistent with the 255
	322	+	state health plan, a written explanation of the reasons for the 256
	323	+	inconsistency shall be included in the decision. In considering whether 257
	324	+	there is clear public need for any request for additional nursing home 258
	325	+	beds associated with a continuing care facility submitted pursuant to 259
	326	+	section 17b-354, the commissioner shall only consider the need for beds 260
	327	+	for current and prospective residents of the continuing care facility.] In 261
	328	+	considering whether there is clear public need for any request for the 262
	329	+	relocation of beds to a replacement facility, the commissioner shall 263
	330	+	consider whether there is a demonstrated bed need in the towns within 264
	331	+	a fifteen-mile radius of the town in which the beds are proposed to be 265
	332	+	located and whether the availability of beds in the applicant's service 266
	333	+	area will be adversely affected. Any proposal to relocate nursing home 267
	334	+	beds from an existing facility to a new facility shall not increase the 268
	335	+	number of Medicaid certified beds and shall result in the closure of at 269
	336	+	least one currently licensed facility other than the facility that is being 270
	337	+	replaced. The commissioner may request that any applicant seeking to 271
	338	+	replace an existing facility reduce the number of beds in the new facility 272
	339	+	by a percentage that is consistent with the department's strategic plan 273
	340	+	for long-term care. The commissioner shall also consider whether an 274
	341	+	application to establish a new or replacement nursing facility proposes 275
	342	+	a nontraditional, small-house style nursing facility and incorporates 276
	343	+	goals for nursing facilities referenced in the department's strategic plan 277
	344	+	for long-term care, including, but not limited to, (1) promoting person-278
	345	+	centered care, (2) providing enhanced quality of care, (3) creating 279
	346	+	community space for all nursing facility residents, and (4) developing 280
	347	+	stronger connections between the nursing facility residents and the 281
	348	+	surrounding community. Bed need shall be based on the recent 282
	349	+	occupancy percentage of area nursing facilities and the projected bed 283
	350	+	need for no more than five years into the future at ninety-seven and one-284
	351	+	half per cent occupancy using the latest official population projections 285
	352	+	by town and age as published by the Office of Policy and Management 286
	353	+	and the latest available state-wide nursing facility utilization statistics 287 Raised Bill No. 290
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358	356
359		-	applicant's current utilization statistics and the effect of the proposal on 287
360		-	the utilization statistics of other facilities in the applicant's service area, 288
361		-	the business interests of all owners, partners, associates, incorporators, 289
362		-	directors, sponsors, stockholders and operators and the personal 290
363		-	background of such persons, and any other factor which the 291
364		-	[department] Department of Social Services deems relevant. [Whenever 292
365		-	the granting, modification or denial of a request is inconsistent with the 293
366		-	state health plan, a written explanation of the reasons for the 294
367		-	inconsistency shall be included in the decision. In considering whether 295
368		-	there is clear public need for any request for additional nursing home 296
369		-	beds associated with a continuing care facility submitted pursuant to 297
370		-	section 17b-354, the commissioner shall only consider the need for beds 298
371		-	for current and prospective residents of the continuing care facility.] In 299
372		-	considering whether there is clear public need for any request for the 300
373		-	relocation of beds to a replacement facility, the commissioner shall 301
374		-	consider whether there is a demonstrated bed need in the towns within 302
375		-	a fifteen-mile radius of the town in which the beds are proposed to be 303
376		-	located and whether the availability of beds in the applicant's service 304
377		-	area will be adversely affected. Any proposal to relocate nursing home 305
378		-	beds from an existing facility to a new facility shall not increase the 306
379		-	number of Medicaid certified beds and shall result in the closure of at 307
380		-	least one currently licensed facility other than the facility that is being 308
381		-	replaced. The commissioner may request that any applicant seeking to 309
382		-	replace an existing facility reduce the number of beds in the new facility 310
383		-	by a percentage that is consistent with the department's strategic plan 311
384		-	for long-term care. If an applicant seeking to replace an existing facility 312
385		-	with a new facility owns or operates more than one nursing facility, the 313
386		-	commissioner may request that the applicant close two or more facilities 314
387		-	before approving the proposal to build a new facility. The commissioner 315
388		-	shall also consider whether an application to establish a new or 316
389		-	replacement nursing facility proposes a nontraditional, small-house 317
390		-	style nursing facility and incorporates goals for nursing facilities 318
391		-	referenced in the department's strategic plan for long-term care, 319
392		-	including, but not limited to, (1) promoting person-centered care, (2) 320
393		-	providing enhanced quality of care, (3) creating community space for all 321 Substitute Bill No. 290
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399		-
400		-	nursing facility residents, and (4) developing stronger connections 322
401		-	between the nursing facility residents and the surrounding community. 323
402		-	Bed need shall be based on the recent occupancy percentage of area 324
403		-	nursing facilities and the projected bed need for no more than five years 325
404		-	into the future at ninety-seven and one-half per cent occupancy using 326
405		-	the latest official population projections by town and age as published 327
406		-	by the Office of Policy and Management and the latest available state-328
407		-	wide nursing facility utilization statistics by age cohort from the 329
408		-	Department of Public Health. The commissioner may also consider area 330
409		-	specific utilization and reductions in utilization rates to account for the 331
410		-	increased use of less institutional alternatives. 332
	359	+	by age cohort from the Department of Public Health. The commissioner 288
	360	+	may also consider area specific utilization and reductions in utilization 289
	361	+	rates to account for the increased use of less institutional alternatives.290
411	362		This act shall take effect as follows and shall amend the following
412	363		sections:
413	364
414	365		Section 1 July 1, 2022 17b-352
415		-	Sec. 2 July 1, 2022 17b-353(c) ~~and (d)~~
	366	+	Sec. 2 July 1, 2022 17b-353(c)
416	367		Sec. 3 July 1, 2022 17b-354(a)
417	368		Sec. 4 July 1, 2022 17b-355
418	369
419		-	Statement of ~~Legislative Commissioners~~:
420		-	~~In Section 1(b), "nursing facility beds" was changed~~ to ~~"licensed nursing~~
421		-	~~facility beds"~~ ~~for consistency~~.
422		-
423		-	~~HS Joint Favorable Subst.~~
	370	+	Statement of Purpose:
	371	+	To modify the certificate of need process for long-term care facilities.
	372	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	373	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	374	+	underlined.]
424	375