Connecticut 2023 Regular Session

Connecticut Senate Bill SB00946 Compare Versions

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7	7		General Assembly Substitute Bill No. 946
8	8		January Session, 2023
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15	14		AN ACT CONCERNING THE CONNECTICUT HOME -CARE PROGRAM
16	15		FOR THE ELDERLY.
17	16		Be it enacted by the Senate and House of Representatives in General
18	17		Assembly convened:
19	18
20	19		Section 1. Subsection (c) of section 17b-342 of the general statutes is 1
21	20		repealed and the following is substituted in lieu thereof (Effective July 2
22	21		1, 2023): 3
23	22		(c) The community-based services covered under the program shall 4
24	23		include, but not be limited to, the following services to the extent that 5
25	24		they are not available under the state Medicaid plan, occupational 6
26	25		therapy, homemaker services, companion services, meals on wheels, 7
27	26		adult day care, transportation, mental health counseling, care 8
28	27		management, [elderly foster care] adult family living, minor home 9
29	28		modifications and assisted living services provided in state-funded 10
30	29		congregate housing and in other assisted living pilot or demonstration 11
31	30		projects established under state law. Personal care assistance services 12
32	31		shall be covered under the program to the extent that (1) such services 13
33	32		are not available under the Medicaid state plan and are more cost 14
34	33		effective on an individual client basis than existing services covered 15
35	34		under such plan, and (2) the provision of such services is approved by 16
36	35		the federal government. A family caregiver, including, but not limited 17
37	36		to, a spouse, who provides personal care assistance services to an 18
38	37		individual enrolled in the program shall be compensated to the extent 19 Substitute Bill No. 946
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45	44		permissible under federal law. Recipients of state-funded services and 20
46	45		persons who are determined to be functionally eligible for community-21
47	46		based services who have an application for medical assistance pending 22
48	47		shall have the cost of home health and community-based services 23
49	48		covered by the program, provided they comply with all medical 24
50	49		assistance application requirements. Access agencies shall not use 25
51	50		department funds to purchase community-based services or home 26
52	51		health services from themselves or any related parties. 27
53	52		Sec. 2. Subsection (i) of section 17b-342 of the general statutes is 28
54	53		repealed and the following is substituted in lieu thereof (Effective July 29
55	54		1, 2023): 30
56	55		(i) (1) The Commissioner of Social Services shall, within available 31
57	56		appropriations, administer a state-funded portion of the program for 32
58	57		persons (A) who are sixty-five years of age and older; (B) who are 33
59	58		inappropriately institutionalized or at risk of inappropriate 34
60	59		institutionalization; (C) whose income is less than or equal to the 35
61	60		amount allowed under subdivision (3) of subsection (a) of this section; 36
62	61		and (D) whose assets, if single, do not exceed one hundred fifty per 37
63	62		cent of the federal minimum community spouse protected amount 38
64	63		pursuant to 42 USC 1396r-5(f)(2) or, if married, the couple's assets do 39
65	64		not exceed two hundred per cent of said community spouse protected 40
66	65		amount. [For program applications received by the Department of 41
67	66		Social Services for the fiscal years ending June 30, 2016, and June 30, 42
68	67		2017, only persons who require the level of care provided in a nursing 43
69	68		home shall be eligible for the state-funded portion of the program, 44
70	69		except for persons residing in affordable housing under the assisted 45
71	70		living demonstration project established pursuant to section 17b-347e 46
72	71		who are otherwise eligible in accordance with this section.] 47
73	72		(2) Except for persons residing in affordable housing under the 48
74	73		assisted living demonstration project established pursuant to section 49
75	74		17b-347e, as provided in subdivision (3) of this subsection, any person 50
76	75		whose income is at or below two hundred per cent of the federal 51
77	76		poverty level and who is ineligible for Medicaid shall contribute 52 Substitute Bill No. 946
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84	83		[three] two per cent of the cost of his or her care. Any person whose 53
85	84		income exceeds two hundred per cent of the federal poverty level shall 54
86	85		contribute [three] two per cent of the cost of his or her care in addition 55
87	86		to the amount of applied income determined in accordance with the 56
88	87		methodology established by the Department of Social Services for 57
89	88		recipients of medical assistance. Any person who does not contribute 58
90	89		to the cost of care in accordance with this subdivision shall be 59
91	90		ineligible to receive services under this subsection. Notwithstanding 60
92	91		any provision of sections 17b-60 and 17b-61, the department shall not 61
93	92		be required to provide an administrative hearing to a person found 62
94	93		ineligible for services under this subsection because of a failure to 63
95	94		contribute to the cost of care. 64
96	95		(3) Any person who resides in affordable housing under the assisted 65
97	96		living demonstration project established pursuant to section 17b-347e 66
98	97		and whose income is at or below two hundred per cent of the federal 67
99	98		poverty level, shall not be required to contribute to the cost of care. 68
100	99		Any person who resides in affordable housing under the assisted 69
101	100		living demonstration project established pursuant to section 17b-347e 70
102	101		and whose income exceeds two hundred per cent of the federal 71
103	102		poverty level, shall contribute to the applied income amount 72
104	103		determined in accordance with the methodology established by the 73
105	104		Department of Social Services for recipients of medical assistance. Any 74
106	105		person whose income exceeds two hundred per cent of the federal 75
107	106		poverty level and who does not contribute to the cost of care in 76
108	107		accordance with this subdivision shall be ineligible to receive services 77
109	108		under this subsection. Notwithstanding any provision of sections 17b-78
110	109		60 and 17b-61, the department shall not be required to provide an 79
111	110		administrative hearing to a person found ineligible for services under 80
112	111		this subsection because of a failure to contribute to the cost of care. 81
113	112		(4) The annualized cost of services provided to an individual under 82
114	113		the state-funded portion of the program shall not exceed fifty per cent 83
115	114		of the weighted average cost of care in nursing homes in the state. [, 84
116	115		except an individual who received services costing in excess of such 85 Substitute Bill No. 946
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123	122		amount under the Department of Social Services in the fiscal year 86
124	123		ending June 30, 1992, may continue to receive such services, provided 87
125	124		the annualized cost of such services does not exceed eighty per cent of 88
126	125		the weighted average cost of such nursing home care. ] The 89
127	126		commissioner may allow the cost of services provided to an individual 90
128	127		to exceed the maximum cost established pursuant to this subdivision 91
129	128		in a case of extreme hardship, as determined by the commissioner, 92
130	129		provided in no case shall such cost exceed that of the weighted cost of 93
131	130		such nursing home care. 94
132	131		(5) A family caregiver, including, but not limited to, a spouse, shall 95
133	132		be compensated for any personal care assistance services provided to 96
134	133		an individual enrolled in the program. 97
135		-	Sec. 3. Section 17b-343 of the general statutes is repealed and the 98
136		-	following is substituted in lieu thereof (Effective July 1, 2023): 99
137		-	The Commissioner of Social Services shall establish annually the 100
138		-	maximum allowable rate to be paid by agencies for homemaker 101
139		-	services, chore person services, companion services, respite care, meals 102
140		-	on wheels, adult day care services, case management and assessment 103
141		-	services, transportation, mental health counseling and [elderly foster 104
142		-	care] adult family living. The Commissioner of Social Services shall 105
143		-	prescribe uniform forms on which agencies providing such services 106
144		-	shall report their costs for such services. Such rates shall be determined 107
145		-	on the basis of a reasonable payment for necessary services rendered. 108
146		-	The maximum allowable rates established by the Commissioner of 109
147		-	Social Services for the Connecticut home-care program for the elderly 110
148		-	established under section 17b-342, as amended by this act, shall 111
149		-	constitute the rates required under this section until revised in 112
150		-	accordance with this section. The Commissioner of Social Services shall 113
151		-	establish a fee schedule, to be effective on and after July 1, 1994, for 114
152		-	homemaker services, chore person services, companion services, 115
153		-	respite care, meals on wheels, adult day care services, case 116
154		-	management and assessment services, transportation, mental health 117
155		-	counseling and [elderly foster care] adult family living. The 118 Substitute Bill No. 946
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162		-	commissioner may annually increase the fee schedule based on an 119
163		-	increase in the cost of services. The commissioner shall increase the fee 120
164		-	schedule effective July 1, 2000, by not less than five per cent, for adult 121
165		-	day care services. The commissioner shall increase the fee schedule 122
166		-	effective July 1, 2011, by four dollars per person, per day for adult day 123
167		-	care services. The commissioner shall increase the fee schedule 124
168		-	effective July 1, 2019, for meals on wheels by ten per cent over the fee 125
169		-	schedule for meals on wheels for the previous fiscal year. Effective July 126
170		-	1, 2020, and annually thereafter, the commissioner may increase the fee 127
171		-	schedule for meals on wheels providers serving participants in the 128
172		-	Connecticut home-care program for the elderly by, at a minimum, the 129
173		-	cost-of-living adjustment as measured by the consumer price index. 130
174		-	The commissioner may increase any fee payable to a meals on wheels 131
175		-	provider upon the application of such provider evidencing 132
176		-	extraordinary costs related to delivery of meals on wheels in sparsely 133
177		-	populated rural regions of the state. Nothing contained in this section 134
178		-	shall authorize a payment by the state to any agency for such services 135
179		-	in excess of the amount charged by such agency for such services to 136
180		-	the general public. 137
181		-	Sec. 4. Subsection (b) of section 17b-370 of the general statutes is 138
182		-	repealed and the following is substituted in lieu thereof (Effective July 139
183		-	1, 2023): 140
184		-	(b) The plan developed pursuant to subsection (a) of this section 141
185		-	shall detail the structure of the demonstration project, persons served, 142
186		-	services to be provided and how they will be provided. The plan shall 143
187		-	include a timetable for implementation of the demonstration project on 144
188		-	or after July 1, 2009. The plan shall ensure that the demonstration 145
189		-	project includes, but is not limited to, the provision of the following 146
190		-	services through a Medicaid state plan amendment, a new Medicaid 147
191		-	waiver or modification of an existing home and community-based 148
192		-	Medicaid waiver: Personal care assistance services, twenty-four-hour 149
193		-	care, occupational therapy, homemaker services, companion services, 150
194		-	meals on wheels, adult day care, transportation, mental health 151 Substitute Bill No. 946
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201		-	counseling, care management, [elderly foster care] adult family living, 152
202		-	minor home modifications, assistive technology and assisted living 153
203		-	services. The plan shall ensure that a person participating in the 154
204		-	demonstration project receives the level of care and services 155
205		-	appropriate to maintain such person in such person's home or 156
206		-	community.157
207	134		This act shall take effect as follows and shall amend the following
208	135		sections:
209	136
210	137		Section 1 July 1, 2023 17b-342(c)
211	138		Sec. 2 July 1, 2023 17b-342(i)
212		-	Sec. 3 July 1, 2023 17b-343
213		-	Sec. 4 July 1, 2023 17b-370(b)
214	139
215	140		Statement of Legislative Commissioners:
216	141		In Section 1(c), "family caregivers" was changed to "a family caregiver",
217	142		", but not limited to," was added after "including", "spouses" was
218	143		changed to "spouse", "provide" was changed to "provides" and
219	144		"participants in the program" was changed to "an individual enrolled
220		-	in the program"; in Section 2(i)(5), "services" was added after
	145	+	in the program"; and in Section 2(i)(5), "services" was added after
221	146		"assistance" and "individual in the program" was changed to
222		-	"individual enrolled in the program", for clarity and consistency; and
223		-	Sections 3 and 4 were added to change "elderly foster care" to "[elderly
224		-	foster care] adult family living", for consistency.
	147	+	"individual enrolled in the program", for clarity and consistency.
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226	149		HS Joint Favorable Subst. C/R APP
227		-	APP Joint Favorable Subst.-LCO
228	150