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General Assembly Raised Bill No. 946
January Session, 2023
LCO No. 3546
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING THE CONNECTICUT HOME -CARE PROGRAM
FOR THE ELDERLY.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (c) of section 17b-342 of the general statutes is 1
repealed and the following is substituted in lieu thereof (Effective July 1, 2
2023): 3
(c) The community-based services covered under the program shall 4
include, but not be limited to, the following services to the extent that 5
they are not available under the state Medicaid plan, occupational 6
therapy, homemaker services, companion services, meals on wheels, 7
adult day care, up to two social worker visits per participant in the 8
program, transportation, mental health counseling, care management, 9
elderly foster care, minor home modifications and assisted living 10
services provided in state-funded congregate housing and in other 11
assisted living pilot or demonstration projects established under state 12
law. Personal care assistance services shall be covered under the 13
program to the extent that (1) such services are not available under the 14
Medicaid state plan and are more cost effective on an individual client 15 Raised Bill No. 946
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basis than existing services covered under such plan, and (2) the 16
provision of such services is approved by the federal government. 17
Family caregivers, including spouses, who provide personal care 18
assistance services to participants in the program shall be compensated 19
to the extent permissible under federal law. Recipients of state-funded 20
services and persons who are determined to be functionally eligible for 21
community-based services who have an application for medical 22
assistance pending shall have the cost of home health and community-23
based services covered by the program, provided they comply with all 24
medical assistance application requirements. Access agencies shall not 25
use department funds to purchase community-based services or home 26
health services from themselves or any related parties. 27
Sec. 2. Subsection (i) of section 17b-342 of the general statutes is 28
repealed and the following is substituted in lieu thereof (Effective July 1, 29
2023): 30
(i) (1) The Commissioner of Social Services shall, within available 31
appropriations, administer a state-funded portion of the program for 32
persons (A) who are sixty-five years of age and older; (B) who are 33
inappropriately institutionalized or at risk of inappropriate 34
institutionalization; (C) whose income is less than or equal to the 35
amount allowed under subdivision (3) of subsection (a) of this section; 36
and (D) whose assets, if single, do not exceed one hundred fifty per cent 37
of the federal minimum community spouse protected amount pursuant 38
to 42 USC 1396r-5(f)(2) or, if married, the couple's assets do not exceed 39
two hundred per cent of said community spouse protected amount. [For 40
program applications received by the Department of Social Services for 41
the fiscal years ending June 30, 2016, and June 30, 2017, only persons 42
who require the level of care provided in a nursing home shall be 43
eligible for the state-funded portion of the program, except for persons 44
residing in affordable housing under the assisted living demonstration 45
project established pursuant to section 17b-347e who are otherwise 46
eligible in accordance with this section.] 47
(2) Except for persons residing in affordable housing under the 48 Raised Bill No. 946
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assisted living demonstration project established pursuant to section 49
17b-347e, as provided in subdivision (3) of this subsection, any person 50
whose income is at or below two hundred per cent of the federal poverty 51
level and who is ineligible for Medicaid shall contribute [three] two per 52
cent of the cost of his or her care. Any person whose income exceeds two 53
hundred per cent of the federal poverty level shall contribute [three] two 54
per cent of the cost of his or her care in addition to the amount of applied 55
income determined in accordance with the methodology established by 56
the Department of Social Services for recipients of medical assistance. 57
Any person who does not contribute to the cost of care in accordance 58
with this subdivision shall be ineligible to receive services under this 59
subsection. Notwithstanding any provision of sections 17b-60 and 17b-60
61, the department shall not be required to provide an administrative 61
hearing to a person found ineligible for services under this subsection 62
because of a failure to contribute to the cost of care. 63
(3) Any person who resides in affordable housing under the assisted 64
living demonstration project established pursuant to section 17b-347e 65
and whose income is at or below two hundred per cent of the federal 66
poverty level, shall not be required to contribute to the cost of care. Any 67
person who resides in affordable housing under the assisted living 68
demonstration project established pursuant to section 17b-347e and 69
whose income exceeds two hundred per cent of the federal poverty 70
level, shall contribute to the applied income amount determined in 71
accordance with the methodology established by the Department of 72
Social Services for recipients of medical assistance. Any person whose 73
income exceeds two hundred per cent of the federal poverty level and 74
who does not contribute to the cost of care in accordance with this 75
subdivision shall be ineligible to receive services under this subsection. 76
Notwithstanding any provision of sections 17b-60 and 17b-61, the 77
department shall not be required to provide an administrative hearing 78
to a person found ineligible for services under this subsection because 79
of a failure to contribute to the cost of care. 80
(4) The annualized cost of services provided to an individual under 81
the state-funded portion of the program shall not exceed fifty per cent 82 Raised Bill No. 946
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of the weighted average cost of care in nursing homes in the state. [, 83
except an individual who received services costing in excess of such 84
amount under the Department of Social Services in the fiscal year 85
ending June 30, 1992, may continue to receive such services, provided 86
the annualized cost of such services does not exceed eighty per cent of 87
the weighted average cost of such nursing home care.] Services 88
provided to an individual in the program shall include up to two visits 89
by a licensed social worker. The commissioner may allow the cost of 90
services provided to an individual to exceed the maximum cost 91
established pursuant to this subdivision in a case of extreme hardship, 92
as determined by the commissioner, provided in no case shall such cost 93
exceed that of the weighted cost of such nursing home care. 94
(5) A family caregiver, including, but not limited to, a spouse, shall 95
be compensated for any personal care assistance provided to an 96
individual in the program. 97
Sec. 3. Subsection (a) of section 17b-242 of the general statutes is 98
repealed and the following is substituted in lieu thereof (Effective July 1, 99
2023): 100
(a) The Department of Social Services shall determine the rates to be 101
paid to home health care agencies and home health aide agencies by the 102
state or any town in the state for persons aided or cared for by the state 103
or any such town. The Commissioner of Social Services shall establish a 104
fee schedule for home health services to be effective on and after July 1, 105
1994. The commissioner may annually modify such fee schedule if such 106
modification is needed to ensure that the conversion to an 107
administrative services organization is cost neutral to home health care 108
agencies and home health aide agencies in the aggregate and ensures 109
patient access. Utilization may be a factor in determining cost neutrality. 110
The commissioner shall increase the fee schedule for home health 111
services provided under the Connecticut home-care program for the 112
elderly established under section 17b-342, as amended by this act, 113
effective July 1, 2000, by two per cent over the fee schedule for home 114
health services for the previous year. The fee schedule shall include up 115 Raised Bill No. 946
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to two visits by a licensed social worker to an individual enrolled in the 116
Connecticut home-care program for the elderly. The commissioner may 117
increase any fee payable to a home health care agency or home health 118
aide agency upon the application of such an agency evidencing 119
extraordinary costs related to (1) serving persons with AIDS; (2) high-120
risk maternal and child health care; (3) escort services; or (4) extended 121
hour services. In no case shall any rate or fee exceed the charge to the 122
general public for similar services. A home health care agency or home 123
health aide agency which, due to any material change in circumstances, 124
is aggrieved by a rate determined pursuant to this subsection may, 125
within ten days of receipt of written notice of such rate from the 126
Commissioner of Social Services, request in writing a hearing on all 127
items of aggrievement. The commissioner shall, upon the receipt of all 128
documentation necessary to evaluate the request, determine whether 129
there has been such a change in circumstances and shall conduct a 130
hearing if appropriate. The Commissioner of Social Services shall adopt 131
regulations, in accordance with chapter 54, to implement the provisions 132
of this subsection. The commissioner may implement policies and 133
procedures to carry out the provisions of this subsection while in the 134
process of adopting regulations, provided notice of intent to adopt the 135
regulations is published in the Connecticut Law Journal not later than 136
twenty days after the date of implementing the policies and procedures. 137
Such policies and procedures shall be valid for not longer than nine 138
months. 139
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2023 17b-342(c)
Sec. 2 July 1, 2023 17b-342(i)
Sec. 3 July 1, 2023 17b-242(a)
Statement of Purpose:
To expand access to the state-funded portion of the Connecticut home-
care program for the elderly, compensate family caregivers and
authorize and compensate up to two visits by licensed social workers to
home-care clients. Raised Bill No. 946
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[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]