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General Assembly Substitute Bill No. 946
January Session, 2023
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repealed and the following is substituted in lieu thereof (Effective July 2
1, 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, transportation, mental health counseling, care 8
management, [elderly foster care] adult family living, minor home 9
modifications and assisted living services provided in state-funded 10
congregate housing and in other assisted living pilot or demonstration 11
projects established under state law. Personal care assistance services 12
shall be covered under the program to the extent that (1) such services 13
are not available under the Medicaid state plan and are more cost 14
effective on an individual client basis than existing services covered 15
under such plan, and (2) the provision of such services is approved by 16
the federal government. A family caregiver, including, but not limited 17
to, a spouse, who provides personal care assistance services to an 18
individual enrolled in the program shall be compensated to the extent 19 Substitute Bill No. 946
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permissible under federal law. Recipients of state-funded services and 20
persons who are determined to be functionally eligible for community-21
based services who have an application for medical assistance pending 22
shall have the cost of home health and community-based services 23
covered by the program, provided they comply with all medical 24
assistance application requirements. Access agencies shall not use 25
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repealed and the following is substituted in lieu thereof (Effective July 29
1, 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 37
cent of the federal minimum community spouse protected amount 38
pursuant to 42 USC 1396r-5(f)(2) or, if married, the couple's assets do 39
not exceed two hundred per cent of said community spouse protected 40
amount. [For program applications received by the Department of 41
Social Services for the fiscal years ending June 30, 2016, and June 30, 42
2017, only persons who require the level of care provided in a nursing 43
home shall be eligible for the state-funded portion of the program, 44
except for persons residing in affordable housing under the assisted 45
living demonstration project established pursuant to section 17b-347e 46
who are otherwise eligible in accordance with this section.] 47
(2) Except for persons residing in affordable housing under the 48
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 51
poverty level and who is ineligible for Medicaid shall contribute 52 Substitute Bill No. 946
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[three] two per cent of the cost of his or her care. Any person whose 53
income exceeds two hundred per cent of the federal poverty level shall 54
contribute [three] two per cent of the cost of his or her care in addition 55
to the amount of applied income determined in accordance with the 56
methodology established by the Department of Social Services for 57
recipients of medical assistance. Any person who does not contribute 58
to the cost of care in accordance with this subdivision shall be 59
ineligible to receive services under this subsection. Notwithstanding 60
any provision of sections 17b-60 and 17b-61, the department shall not 61
be required to provide an administrative hearing to a person found 62
ineligible for services under this subsection because of a failure to 63
contribute to the cost of care. 64
(3) Any person who resides in affordable housing under the assisted 65
living demonstration project established pursuant to section 17b-347e 66
and whose income is at or below two hundred per cent of the federal 67
poverty level, shall not be required to contribute to the cost of care. 68
Any person who resides in affordable housing under the assisted 69
living demonstration project established pursuant to section 17b-347e 70
and whose income exceeds two hundred per cent of the federal 71
poverty level, shall contribute to the applied income amount 72
determined in accordance with the methodology established by the 73
Department of Social Services for recipients of medical assistance. Any 74
person whose income exceeds two hundred per cent of the federal 75
poverty level and who does not contribute to the cost of care in 76
accordance with this subdivision shall be ineligible to receive services 77
under this subsection. Notwithstanding any provision of sections 17b-78
60 and 17b-61, the department shall not be required to provide an 79
administrative hearing to a person found ineligible for services under 80
this subsection because of a failure to contribute to the cost of care. 81
(4) The annualized cost of services provided to an individual under 82
the state-funded portion of the program shall not exceed fifty per cent 83
of the weighted average cost of care in nursing homes in the state. [, 84
except an individual who received services costing in excess of such 85 Substitute Bill No. 946
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amount under the Department of Social Services in the fiscal year 86
ending June 30, 1992, may continue to receive such services, provided 87
the annualized cost of such services does not exceed eighty per cent of 88
the weighted average cost of such nursing home care.] The 89
commissioner may allow the cost of services provided to an individual 90
to exceed the maximum cost established pursuant to this subdivision 91
in a case of extreme hardship, as determined by the commissioner, 92
provided in no case shall such cost exceed that of the weighted cost of 93
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 services provided to 96
an individual enrolled in the program. 97
Sec. 3. Section 17b-343 of the general statutes is repealed and the 98
following is substituted in lieu thereof (Effective July 1, 2023): 99
The Commissioner of Social Services shall establish annually the 100
maximum allowable rate to be paid by agencies for homemaker 101
services, chore person services, companion services, respite care, meals 102
on wheels, adult day care services, case management and assessment 103
services, transportation, mental health counseling and [elderly foster 104
care] adult family living. The Commissioner of Social Services shall 105
prescribe uniform forms on which agencies providing such services 106
shall report their costs for such services. Such rates shall be determined 107
on the basis of a reasonable payment for necessary services rendered. 108
The maximum allowable rates established by the Commissioner of 109
Social Services for the Connecticut home-care program for the elderly 110
established under section 17b-342, as amended by this act, shall 111
constitute the rates required under this section until revised in 112
accordance with this section. The Commissioner of Social Services shall 113
establish a fee schedule, to be effective on and after July 1, 1994, for 114
homemaker services, chore person services, companion services, 115
respite care, meals on wheels, adult day care services, case 116
management and assessment services, transportation, mental health 117
counseling and [elderly foster care] adult family living. The 118 Substitute Bill No. 946
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commissioner may annually increase the fee schedule based on an 119
increase in the cost of services. The commissioner shall increase the fee 120
schedule effective July 1, 2000, by not less than five per cent, for adult 121
day care services. The commissioner shall increase the fee schedule 122
effective July 1, 2011, by four dollars per person, per day for adult day 123
care services. The commissioner shall increase the fee schedule 124
effective July 1, 2019, for meals on wheels by ten per cent over the fee 125
schedule for meals on wheels for the previous fiscal year. Effective July 126
1, 2020, and annually thereafter, the commissioner may increase the fee 127
schedule for meals on wheels providers serving participants in the 128
Connecticut home-care program for the elderly by, at a minimum, the 129
cost-of-living adjustment as measured by the consumer price index. 130
The commissioner may increase any fee payable to a meals on wheels 131
provider upon the application of such provider evidencing 132
extraordinary costs related to delivery of meals on wheels in sparsely 133
populated rural regions of the state. Nothing contained in this section 134
shall authorize a payment by the state to any agency for such services 135
in excess of the amount charged by such agency for such services to 136
the general public. 137
Sec. 4. Subsection (b) of section 17b-370 of the general statutes is 138
repealed and the following is substituted in lieu thereof (Effective July 139
1, 2023): 140
(b) The plan developed pursuant to subsection (a) of this section 141
shall detail the structure of the demonstration project, persons served, 142
services to be provided and how they will be provided. The plan shall 143
include a timetable for implementation of the demonstration project on 144
or after July 1, 2009. The plan shall ensure that the demonstration 145
project includes, but is not limited to, the provision of the following 146
services through a Medicaid state plan amendment, a new Medicaid 147
waiver or modification of an existing home and community-based 148
Medicaid waiver: Personal care assistance services, twenty-four-hour 149
care, occupational therapy, homemaker services, companion services, 150
meals on wheels, adult day care, transportation, mental health 151 Substitute Bill No. 946
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counseling, care management, [elderly foster care] adult family living, 152
minor home modifications, assistive technology and assisted living 153
services. The plan shall ensure that a person participating in the 154
demonstration project receives the level of care and services 155
appropriate to maintain such person in such person's home or 156
community.157
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-343
Sec. 4 July 1, 2023 17b-370(b)
Statement of Legislative Commissioners:
In Section 1(c), "family caregivers" was changed to "a family caregiver",
", but not limited to," was added after "including", "spouses" was
changed to "spouse", "provide" was changed to "provides" and
"participants in the program" was changed to "an individual enrolled
in the program"; in Section 2(i)(5), "services" was added after
"assistance" and "individual in the program" was changed to
"individual enrolled in the program", for clarity and consistency; and
Sections 3 and 4 were added to change "elderly foster care" to "[elderly
foster care] adult family living", for consistency.
HS Joint Favorable Subst. C/R APP
APP Joint Favorable Subst.-LCO