Connecticut 2024 Regular Session

Connecticut House Bill HB05296 Compare Versions

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Version 2 (New)

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7		-	General Assembly ~~Substitute~~ Bill No. 5296
	5	+	General Assembly Raised Bill No. 5296
8	6		February Session, 2024
	7	+	LCO No. 1858
	8	+
	9	+
	10	+	Referred to Committee on AGING
	11	+
	12	+
	13	+	Introduced by:
	14	+	(AGE)
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13		-
14		-	~~AN ACT~~ EXPANDING THE CONNECTICUT HOME -CARE PROGRAM
15		-	~~FOR THE~~ ELDERLY.
	19	+	AN ACT CONCERNING FAMILY HOME CARE OVERSIGHT AND
	20	+	EXPANDING THE CONNECTICUT HOME-CARE PROGRAM FOR THE
	21	+	ELDERLY.
16	22		Be it enacted by the Senate and House of Representatives in General
17	23		Assembly convened:
18	24
19		-	Section 1. Section 17b-342 of the general statutes is repealed and the 1
20		-	following is substituted in lieu thereof (Effective July 1, 2024): 2
21		-	(a) The Commissioner of Social Services shall administer the 3
22		-	Connecticut home-care program for the elderly state-wide in order to 4
23		-	prevent the institutionalization of elderly persons (1) who are recipients 5
24		-	of medical assistance, (2) who are eligible for such assistance, (3) who 6
25		-	would be eligible for medical assistance if residing in a nursing facility, 7
26		-	or (4) who meet the criteria for the state-funded portion of the program 8
27		-	under subsection (i) of this section. For purposes of this section, a long-9
28		-	term care facility is a facility that has been federally certified as a skilled 10
29		-	nursing facility or intermediate care facility. The commissioner shall 11
30		-	make any revisions in the state Medicaid plan required by Title XIX of 12
31		-	the Social Security Act prior to implementing the program. The program 13
32		-	shall be structured so that the net cost to the state for long-term facility 14
33		-	care in combination with the services under the program shall not 15
34		-	exceed the net cost the state would have incurred without the program. 16
35		-	The commissioner shall investigate the possibility of receiving federal 17
36		-	funds for the program and shall apply for any necessary federal 18 Substitute Bill No. 5296
	25	+	Section 1. (Effective from passage) The Commissioner of Social Services 1
	26	+	shall conduct a study on home care services provided by family 2
	27	+	members in the state. Such study shall (1) examine the department's 3
	28	+	procedures for overseeing such services, (2) identify the number of 4
	29	+	complaints received by the department concerning such services and 5
	30	+	the resolution of such complaints, and (3) develop recommendations for 6
	31	+	increasing accountability and oversight of home care services. Not later 7
	32	+	than January 1, 2025, the commissioner shall report on such study, in 8
	33	+	accordance with the provisions of section 11-4a of the general statutes, 9
	34	+	to the joint standing committees of the General Assembly having 10
	35	+	cognizance of matters relating to human services and aging. For the 11
	36	+	purposes of this section, "home care" means long-term services and 12
	37	+	supports provided to adults in a home or community-based program 13
	38	+	administered by the Department of Social Services. 14 Raised Bill No. 5296
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43		-	waivers. A recipient of services under the program, and the estate and 19
44		-	legally liable relatives of the recipient, shall be responsible for 20
45		-	reimbursement to the state for such services to the same extent required 21
46		-	of a recipient of assistance under the state supplement program, medical 22
47		-	assistance program, temporary family assistance program or 23
48		-	supplemental nutrition assistance program. Only a United States citizen 24
49		-	or a noncitizen who meets the citizenship requirements for eligibility 25
50		-	under the Medicaid program shall be eligible for home-care services 26
51		-	under this section, except a qualified alien, as defined in Section 431 of 27
52		-	Public Law 104-193, admitted into the United States on or after August 28
53		-	22, 1996, or other lawfully residing immigrant alien determined eligible 29
54		-	for services under this section prior to July 1, 1997, shall remain eligible 30
55		-	for such services. Qualified aliens or other lawfully residing immigrant 31
56		-	aliens not determined eligible prior to July 1, 1997, shall be eligible for 32
57		-	services under this section subsequent to six months from establishing 33
58		-	residency. Notwithstanding the provisions of this subsection, any 34
59		-	qualified alien or other lawfully residing immigrant alien or alien who 35
60		-	formerly held the status of permanently residing under color of law who 36
61		-	is a victim of domestic violence or who has intellectual disability shall 37
62		-	be eligible for assistance pursuant to this section. Qualified aliens, as 38
63		-	defined in Section 431 of Public Law 104-193, or other lawfully residing 39
64		-	immigrant aliens or aliens who formerly held the status of permanently 40
65		-	residing under color of law shall be eligible for services under this 41
66		-	section provided other conditions of eligibility are met. 42
67		-	(b) The commissioner shall solicit bids through a competitive process 43
68		-	and shall contract with an access agency, approved by the Office of 44
69		-	Policy and Management and the Department of Social Services as 45
70		-	meeting the requirements for such agency as defined by regulations 46
71		-	adopted pursuant to subsection (e) of this section, that submits 47
72		-	proposals which meet or exceed the minimum bid requirements. In 48
73		-	addition to such contracts, the commissioner may use department staff 49
74		-	to provide screening, coordination, assessment and monitoring 50
75		-	functions for the program. 51 Substitute Bill No. 5296
	42	+	LCO No. 1858 2 of 10
	43	+
	44	+	Sec. 2. Section 17b-342 of the general statutes is repealed and the 15
	45	+	following is substituted in lieu thereof (Effective July 1, 2024): 16
	46	+	(a) The Commissioner of Social Services shall administer the 17
	47	+	Connecticut home-care program for the elderly state-wide in order to 18
	48	+	prevent the institutionalization of elderly persons (1) who are recipients 19
	49	+	of medical assistance, (2) who are eligible for such assistance, (3) who 20
	50	+	would be eligible for medical assistance if residing in a nursing facility, 21
	51	+	or (4) who meet the criteria for the state-funded portion of the program 22
	52	+	under subsection (i) of this section. For purposes of this section, a long-23
	53	+	term care facility is a facility that has been federally certified as a skilled 24
	54	+	nursing facility or intermediate care facility. The commissioner shall 25
	55	+	make any revisions in the state Medicaid plan required by Title XIX of 26
	56	+	the Social Security Act prior to implementing the program. The program 27
	57	+	shall be structured so that the net cost to the state for long-term facility 28
	58	+	care in combination with the services under the program shall not 29
	59	+	exceed the net cost the state would have incurred without the program. 30
	60	+	The commissioner shall investigate the possibility of receiving federal 31
	61	+	funds for the program and shall apply for any necessary federal 32
	62	+	waivers. A recipient of services under the program, and the estate and 33
	63	+	legally liable relatives of the recipient, shall be responsible for 34
	64	+	reimbursement to the state for such services to the same extent required 35
	65	+	of a recipient of assistance under the state supplement program, medical 36
	66	+	assistance program, temporary family assistance program or 37
	67	+	supplemental nutrition assistance program. Only a United States citizen 38
	68	+	or a noncitizen who meets the citizenship requirements for eligibility 39
	69	+	under the Medicaid program shall be eligible for home-care services 40
	70	+	under this section, except a qualified alien, as defined in Section 431 of 41
	71	+	Public Law 104-193, admitted into the United States on or after August 42
	72	+	22, 1996, or other lawfully residing immigrant alien determined eligible 43
	73	+	for services under this section prior to July 1, 1997, shall remain eligible 44
	74	+	for such services. Qualified aliens or other lawfully residing immigrant 45
	75	+	aliens not determined eligible prior to July 1, 1997, shall be eligible for 46
	76	+	services under this section subsequent to six months from establishing 47
	77	+	residency. Notwithstanding the provisions of this subsection, any 48 Raised Bill No. 5296
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82		-	(c) The community-based services covered under the program shall 52
83		-	include, but not be limited to, the following services to the extent that 53
84		-	they are not available under the state Medicaid plan, occupational 54
85		-	therapy, homemaker services, companion services, meals on wheels, 55
86		-	adult day care, transportation, mental health counseling, care 56
87		-	management, [elderly foster care] adult family living, minor home 57
88		-	modifications and assisted living services provided in state-funded 58
89		-	congregate housing and in other assisted living pilot or demonstration 59
90		-	projects established under state law. Personal care assistance services 60
91		-	shall be covered under the program to the extent that (1) such services 61
92		-	are not available under the Medicaid state plan and are more cost 62
93		-	effective on an individual client basis than existing services covered 63
94		-	under such plan, and (2) the provision of such services is approved by 64
95		-	the federal government. A family caregiver, including, but not limited 65
96		-	to, a spouse, who provides personal care assistance services to an 66
97		-	individual enrolled in the program shall be compensated to the extent 67
98		-	permissible under federal law. Recipients of state-funded services and 68
99		-	persons who are determined to be functionally eligible for community-69
100		-	based services who have an application for medical assistance pending 70
101		-	shall have the cost of home health and community-based services 71
102		-	covered by the program, provided they comply with all medical 72
103		-	assistance application requirements. Access agencies shall not use 73
104		-	department funds to purchase community-based services or home 74
105		-	health services from themselves or any related parties. 75
106		-	(d) Physicians, hospitals, long-term care facilities and other licensed 76
107		-	health care facilities may disclose, and, as a condition of eligibility for 77
108		-	the program, elderly persons, their guardians, and relatives shall 78
109		-	disclose, upon request from the Department of Social Services, such 79
110		-	financial, social and medical information as may be necessary to enable 80
111		-	the department or any agency administering the program on behalf of 81
112		-	the department to provide services under the program. Long-term care 82
113		-	facilities shall supply the Department of Social Services with the names 83
114		-	and addresses of all applicants for admission. Any information 84
115		-	provided pursuant to this subsection shall be confidential and shall not 85 Substitute Bill No. 5296
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	82	+
	83	+	qualified alien or other lawfully residing immigrant alien or alien who 49
	84	+	formerly held the status of permanently residing under color of law who 50
	85	+	is a victim of domestic violence or who has intellectual disability shall 51
	86	+	be eligible for assistance pursuant to this section. Qualified aliens, as 52
	87	+	defined in Section 431 of Public Law 104-193, or other lawfully residing 53
	88	+	immigrant aliens or aliens who formerly held the status of permanently 54
	89	+	residing under color of law shall be eligible for services under this 55
	90	+	section provided other conditions of eligibility are met. 56
	91	+	(b) The commissioner shall solicit bids through a competitive process 57
	92	+	and shall contract with an access agency, approved by the Office of 58
	93	+	Policy and Management and the Department of Social Services as 59
	94	+	meeting the requirements for such agency as defined by regulations 60
	95	+	adopted pursuant to subsection (e) of this section, that submits 61
	96	+	proposals which meet or exceed the minimum bid requirements. In 62
	97	+	addition to such contracts, the commissioner may use department staff 63
	98	+	to provide screening, coordination, assessment and monitoring 64
	99	+	functions for the program. 65
	100	+	(c) The community-based services covered under the program shall 66
	101	+	include, but not be limited to, the following services to the extent that 67
	102	+	they are not available under the state Medicaid plan, occupational 68
	103	+	therapy, homemaker services, companion services, meals on wheels, 69
	104	+	adult day care, transportation, mental health counseling, care 70
	105	+	management, [elderly foster care] adult family living, minor home 71
	106	+	modifications and assisted living services provided in state-funded 72
	107	+	congregate housing and in other assisted living pilot or demonstration 73
	108	+	projects established under state law. Personal care assistance services 74
	109	+	shall be covered under the program to the extent that (1) such services 75
	110	+	are not available under the Medicaid state plan and are more cost 76
	111	+	effective on an individual client basis than existing services covered 77
	112	+	under such plan, and (2) the provision of such services is approved by 78
	113	+	the federal government. A family caregiver, including, but not limited 79
	114	+	to, a spouse, who provides personal care assistance services to an 80
	115	+	individual enrolled in the program shall be compensated to the extent 81
	116	+	permissible under federal law. Recipients of state-funded services and 82 Raised Bill No. 5296
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122		-	be disclosed by the department or administering agency. 86
123		-	(e) The commissioner shall adopt regulations, in accordance with the 87
124		-	provisions of chapter 54, to define "access agency", to implement and 88
125		-	administer the program, to establish uniform state-wide standards for 89
126		-	the program and a uniform assessment tool for use in the screening 90
127		-	process and to specify conditions of eligibility. 91
128		-	(f) The commissioner may require long-term care facilities to inform 92
129		-	applicants for admission of the program established under this section 93
130		-	and to distribute such forms as the commissioner prescribes for the 94
131		-	program. Such forms shall be supplied by and be returnable to the 95
132		-	department. 96
133		-	(g) The commissioner shall report annually, by June first, to the joint 97
134		-	standing committee of the General Assembly having cognizance of 98
135		-	matters relating to human services on the program in such detail, depth 99
136		-	and scope as said committee requires to evaluate the effect of the 100
137		-	program on the state and program participants. Such report shall 101
138		-	include information on (1) the number of persons diverted from 102
139		-	placement in a long-term care facility as a result of the program, (2) the 103
140		-	number of persons screened, (3) the average cost per person in the 104
141		-	program, (4) the administration costs, (5) the estimated savings, [and] 105
142		-	(6) a comparison between costs under the different contracts, and (7) for 106
143		-	adult family living services provided under the program, (A) the 107
144		-	participation rate of individuals receiving services pursuant to this 108
145		-	section, (B) the number of home care agencies that administer adult 109
146		-	family living services, (C) the primary languages spoken by individuals 110
147		-	receiving adult family living services, and (D) the estimated savings for 111
148		-	the state by deferred institutionalization of individuals receiving adult 112
149		-	family living services. 113
150		-	(h) An individual who is otherwise eligible for services pursuant to 114
151		-	this section shall, as a condition of participation in the program, apply 115
152		-	for medical assistance benefits pursuant to section 17b-260 when 116
153		-	requested to do so by the department and shall accept such benefits if 117 Substitute Bill No. 5296
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	121	+
	122	+	persons who are determined to be functionally eligible for community-83
	123	+	based services who have an application for medical assistance pending 84
	124	+	shall have the cost of home health and community-based services 85
	125	+	covered by the program, provided they comply with all medical 86
	126	+	assistance application requirements. Access agencies shall not use 87
	127	+	department funds to purchase community-based services or home 88
	128	+	health services from themselves or any related parties. 89
	129	+	(d) Physicians, hospitals, long-term care facilities and other licensed 90
	130	+	health care facilities may disclose, and, as a condition of eligibility for 91
	131	+	the program, elderly persons, their guardians, and relatives shall 92
	132	+	disclose, upon request from the Department of Social Services, such 93
	133	+	financial, social and medical information as may be necessary to enable 94
	134	+	the department or any agency administering the program on behalf of 95
	135	+	the department to provide services under the program. Long-term care 96
	136	+	facilities shall supply the Department of Social Services with the names 97
	137	+	and addresses of all applicants for admission. Any information 98
	138	+	provided pursuant to this subsection shall be confidential and shall not 99
	139	+	be disclosed by the department or administering agency. 100
	140	+	(e) The commissioner shall adopt regulations, in accordance with the 101
	141	+	provisions of chapter 54, to define "access agency", to implement and 102
	142	+	administer the program, to establish uniform state-wide standards for 103
	143	+	the program and a uniform assessment tool for use in the screening 104
	144	+	process and to specify conditions of eligibility. 105
	145	+	(f) The commissioner may require long-term care facilities to inform 106
	146	+	applicants for admission of the program established under this section 107
	147	+	and to distribute such forms as the commissioner prescribes for the 108
	148	+	program. Such forms shall be supplied by and be returnable to the 109
	149	+	department. 110
	150	+	(g) The commissioner shall report annually, by June first, to the joint 111
	151	+	standing committee of the General Assembly having cognizance of 112
	152	+	matters relating to human services on the program in such detail, depth 113
	153	+	and scope as said committee requires to evaluate the effect of the 114 Raised Bill No. 5296
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160		-	determined eligible. 118
161		-	(i) (1) The Commissioner of Social Services shall, within available 119
162		-	appropriations, administer a state-funded portion of the program for 120
163		-	persons (A) who are sixty-five years of age and older; (B) who are 121
164		-	inappropriately institutionalized or at risk of inappropriate 122
165		-	institutionalization; (C) whose income is less than or equal to the 123
166		-	amount allowed under subdivision (3) of subsection (a) of this section; 124
167		-	and (D) whose assets, if single, do not exceed one hundred fifty per cent 125
168		-	of the federal minimum community spouse protected amount pursuant 126
169		-	to 42 USC 1396r-5(f)(2) or, if married, the couple's assets do not exceed 127
170		-	two hundred per cent of said community spouse protected amount. For 128
171		-	program applications received by the Department of Social Services for 129
172		-	the fiscal years ending June 30, 2016, and June 30, 2017, only persons 130
173		-	who require the level of care provided in a nursing home shall be 131
174		-	eligible for the state-funded portion of the program, except for persons 132
175		-	residing in affordable housing under the assisted living demonstration 133
176		-	project established pursuant to section 17b-347e who are otherwise 134
177		-	eligible in accordance with this section. 135
178		-	(2) Except for persons residing in affordable housing under the 136
179		-	assisted living demonstration project established pursuant to section 137
180		-	17b-347e, as provided in subdivision (3) of this subsection, any person 138
181		-	whose income is at or below two hundred per cent of the federal poverty 139
182		-	level and who is ineligible for Medicaid shall contribute three per cent 140
183		-	of the cost of his or her care. Any person whose income exceeds two 141
184		-	hundred per cent of the federal poverty level shall contribute three per 142
185		-	cent of the cost of his or her care in addition to the amount of applied 143
186		-	income determined in accordance with the methodology established by 144
187		-	the Department of Social Services for recipients of medical assistance. 145
188		-	Any person who does not contribute to the cost of care in accordance 146
189		-	with this subdivision shall be ineligible to receive services under this 147
190		-	subsection. Notwithstanding any provision of sections 17b-60 and 17b-148
191		-	61, the department shall not be required to provide an administrative 149
192		-	hearing to a person found ineligible for services under this subsection 150 Substitute Bill No. 5296
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	158	+
	159	+	program on the state and program participants. Such report shall 115
	160	+	include information on (1) the number of persons diverted from 116
	161	+	placement in a long-term care facility as a result of the program, (2) the 117
	162	+	number of persons screened, (3) the average cost per person in the 118
	163	+	program, (4) the administration costs, (5) the estimated savings, [and] 119
	164	+	(6) a comparison between costs under the different contracts, and (7) for 120
	165	+	adult family living services provided under the program, (A) the 121
	166	+	participation rate of individuals receiving services pursuant to this 122
	167	+	section, (B) the number of home care agencies that administer adult 123
	168	+	family living services, (C) the primary languages spoken by individuals 124
	169	+	receiving adult family living services, and (D) the estimated savings for 125
	170	+	the state by deferred institutionalization of individuals receiving adult 126
	171	+	family living services. 127
	172	+	(h) An individual who is otherwise eligible for services pursuant to 128
	173	+	this section shall, as a condition of participation in the program, apply 129
	174	+	for medical assistance benefits pursuant to section 17b-260 when 130
	175	+	requested to do so by the department and shall accept such benefits if 131
	176	+	determined eligible. 132
	177	+	(i) (1) The Commissioner of Social Services shall, within available 133
	178	+	appropriations, administer a state-funded portion of the program for 134
	179	+	persons (A) who are sixty-five years of age and older; (B) who are 135
	180	+	inappropriately institutionalized or at risk of inappropriate 136
	181	+	institutionalization; (C) whose income is less than or equal to the 137
	182	+	amount allowed under subdivision (3) of subsection (a) of this section; 138
	183	+	and (D) whose assets, if single, do not exceed one hundred fifty per cent 139
	184	+	of the federal minimum community spouse protected amount pursuant 140
	185	+	to 42 USC 1396r-5(f)(2) or, if married, the couple's assets do not exceed 141
	186	+	two hundred per cent of said community spouse protected amount. For 142
	187	+	program applications received by the Department of Social Services for 143
	188	+	the fiscal years ending June 30, 2016, and June 30, 2017, only persons 144
	189	+	who require the level of care provided in a nursing home shall be 145
	190	+	eligible for the state-funded portion of the program, except for persons 146
	191	+	residing in affordable housing under the assisted living demonstration 147
	192	+	project established pursuant to section 17b-347e who are otherwise 148 Raised Bill No. 5296
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199		-	because of a failure to contribute to the cost of care. 151
200		-	(3) Any person who resides in affordable housing under the assisted 152
201		-	living demonstration project established pursuant to section 17b-347e 153
202		-	and whose income is at or below two hundred per cent of the federal 154
203		-	poverty level, shall not be required to contribute to the cost of care. Any 155
204		-	person who resides in affordable housing under the assisted living 156
205		-	demonstration project established pursuant to section 17b-347e and 157
206		-	whose income exceeds two hundred per cent of the federal poverty 158
207		-	level, shall contribute to the applied income amount determined in 159
208		-	accordance with the methodology established by the Department of 160
209		-	Social Services for recipients of medical assistance. Any person whose 161
210		-	income exceeds two hundred per cent of the federal poverty level and 162
211		-	who does not contribute to the cost of care in accordance with this 163
212		-	subdivision shall be ineligible to receive services under this subsection. 164
213		-	Notwithstanding any provision of sections 17b-60 and 17b-61, the 165
214		-	department shall not be required to provide an administrative hearing 166
215		-	to a person found ineligible for services under this subsection because 167
216		-	of a failure to contribute to the cost of care. 168
217		-	(4) The annualized cost of services provided to an individual under 169
218		-	the state-funded portion of the program shall not exceed fifty per cent 170
219		-	of the weighted average cost of care in nursing homes in the state, except 171
220		-	an individual who received services costing in excess of such amount 172
221		-	under the Department of Social Services in the fiscal year ending June 173
222		-	30, 1992, may continue to receive such services, provided the annualized 174
223		-	cost of such services does not exceed eighty per cent of the weighted 175
224		-	average cost of such nursing home care. The commissioner may allow 176
225		-	the cost of services provided to an individual to exceed the maximum 177
226		-	cost established pursuant to this subdivision in a case of extreme 178
227		-	hardship, as determined by the commissioner, provided in no case shall 179
228		-	such cost exceed that of the weighted cost of such nursing home care. 180
229		-	(5) A family caregiver, including, but not limited to, a spouse, shall 181
230		-	be compensated for any personal care assistance services provided to an 182
231		-	individual enrolled in the program. 183 Substitute Bill No. 5296
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	197	+
	198	+	eligible in accordance with this section. 149
	199	+	(2) Except for persons residing in affordable housing under the 150
	200	+	assisted living demonstration project established pursuant to section 151
	201	+	17b-347e, as provided in subdivision (3) of this subsection, any person 152
	202	+	whose income is at or below two hundred per cent of the federal poverty 153
	203	+	level and who is ineligible for Medicaid shall contribute three per cent 154
	204	+	of the cost of his or her care. Any person whose income exceeds two 155
	205	+	hundred per cent of the federal poverty level shall contribute three per 156
	206	+	cent of the cost of his or her care in addition to the amount of applied 157
	207	+	income determined in accordance with the methodology established by 158
	208	+	the Department of Social Services for recipients of medical assistance. 159
	209	+	Any person who does not contribute to the cost of care in accordance 160
	210	+	with this subdivision shall be ineligible to receive services under this 161
	211	+	subsection. Notwithstanding any provision of sections 17b-60 and 17b-162
	212	+	61, the department shall not be required to provide an administrative 163
	213	+	hearing to a person found ineligible for services under this subsection 164
	214	+	because of a failure to contribute to the cost of care. 165
	215	+	(3) Any person who resides in affordable housing under the assisted 166
	216	+	living demonstration project established pursuant to section 17b-347e 167
	217	+	and whose income is at or below two hundred per cent of the federal 168
	218	+	poverty level, shall not be required to contribute to the cost of care. Any 169
	219	+	person who resides in affordable housing under the assisted living 170
	220	+	demonstration project established pursuant to section 17b-347e and 171
	221	+	whose income exceeds two hundred per cent of the federal poverty 172
	222	+	level, shall contribute to the applied income amount determined in 173
	223	+	accordance with the methodology established by the Department of 174
	224	+	Social Services for recipients of medical assistance. Any person whose 175
	225	+	income exceeds two hundred per cent of the federal poverty level and 176
	226	+	who does not contribute to the cost of care in accordance with this 177
	227	+	subdivision shall be ineligible to receive services under this subsection. 178
	228	+	Notwithstanding any provision of sections 17b-60 and 17b-61, the 179
	229	+	department shall not be required to provide an administrative hearing 180
	230	+	to a person found ineligible for services under this subsection because 181
	231	+	of a failure to contribute to the cost of care. 182 Raised Bill No. 5296
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238		-	(j) The Commissioner of Social Services shall collect data on services 184
239		-	provided under the program, including, but not limited to, the: (1) 185
240		-	Number of participants before and after copayments are reduced 186
241		-	pursuant to subsection (i) of this section, (2) average hours of care 187
242		-	provided under the program per participant, and (3) estimated cost 188
243		-	savings to the state by providing home care to participants who may 189
244		-	otherwise receive care in a nursing home facility. The commissioner 190
245		-	shall, in accordance with the provisions of section 11-4a, report on the 191
246		-	results of the data collection to the joint standing committees of the 192
247		-	General Assembly having cognizance of matters relating to aging, 193
248		-	appropriations and the budgets of state agencies and human services 194
249		-	not later than July 1, 2022. The commissioner may implement revised 195
250		-	criteria for the operation of the program while in the process of adopting 196
251		-	such criteria in regulation form, provided the commissioner publishes 197
252		-	notice of intention to adopt the regulations in accordance with section 198
253		-	17b-10. Such criteria shall be valid until the time final regulations are 199
254		-	effective. 200
255		-	(k) The commissioner shall notify any access agency or area agency 201
256		-	on aging that administers the program when the department sends a 202
257		-	redetermination of eligibility form to an individual who is a client of 203
258		-	such agency. 204
259		-	(l) In determining eligibility for the program described in this section, 205
260		-	the commissioner shall not consider as income (1) Aid and Attendance 206
261		-	pension benefits granted to a veteran, as defined in section 27-103, or the 207
262		-	surviving spouse of such veteran, and (2) any tax refund or advance 208
263		-	payment with respect to a refundable credit to the same extent such 209
264		-	refund or advance payment would be disregarded under 26 USC 6409 210
265		-	in any federal program or state or local program financed in whole or in 211
266		-	part with federal funds. 212
267		-	(m) Not later than January 1, 2025, the Commissioner of Social 213
268		-	Services shall develop and implement a multilingual public awareness 214
269		-	campaign to promote adult family living services offered under the 215
270		-	program. Any materials developed for the public awareness campaign 216 Substitute Bill No. 5296
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	236	+
	237	+	(4) The annualized cost of services provided to an individual under 183
	238	+	the state-funded portion of the program shall not exceed fifty per cent 184
	239	+	of the weighted average cost of care in nursing homes in the state, except 185
	240	+	an individual who received services costing in excess of such amount 186
	241	+	under the Department of Social Services in the fiscal year ending June 187
	242	+	30, 1992, may continue to receive such services, provided the annualized 188
	243	+	cost of such services does not exceed eighty per cent of the weighted 189
	244	+	average cost of such nursing home care. The commissioner may allow 190
	245	+	the cost of services provided to an individual to exceed the maximum 191
	246	+	cost established pursuant to this subdivision in a case of extreme 192
	247	+	hardship, as determined by the commissioner, provided in no case shall 193
	248	+	such cost exceed that of the weighted cost of such nursing home care. 194
	249	+	(5) A family caregiver, including, but not limited to, a spouse, shall 195
	250	+	be compensated for any personal care assistance services provided to an 196
	251	+	individual enrolled in the program. 197
	252	+	(j) The Commissioner of Social Services shall collect data on services 198
	253	+	provided under the program, including, but not limited to, the: (1) 199
	254	+	Number of participants before and after copayments are reduced 200
	255	+	pursuant to subsection (i) of this section, (2) average hours of care 201
	256	+	provided under the program per participant, and (3) estimated cost 202
	257	+	savings to the state by providing home care to participants who may 203
	258	+	otherwise receive care in a nursing home facility. The commissioner 204
	259	+	shall, in accordance with the provisions of section 11-4a, report on the 205
	260	+	results of the data collection to the joint standing committees of the 206
	261	+	General Assembly having cognizance of matters relating to aging, 207
	262	+	appropriations and the budgets of state agencies and human services 208
	263	+	not later than July 1, 2022. The commissioner may implement revised 209
	264	+	criteria for the operation of the program while in the process of adopting 210
	265	+	such criteria in regulation form, provided the commissioner publishes 211
	266	+	notice of intention to adopt the regulations in accordance with section 212
	267	+	17b-10. Such criteria shall be valid until the time final regulations are 213
	268	+	effective. 214
	269	+	(k) The commissioner shall notify any access agency or area agency 215 Raised Bill No. 5296
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277		-	shall be translated into the fifteen most commonly spoken languages in 217
278		-	the state, as determined by the commissioner. The commissioner shall 218
279		-	(1) make paper copies of such materials available to the public at various 219
280		-	times and at various locations throughout the state, as determined by 220
281		-	the commissioner, and (2) post a link to such materials on the 221
282		-	department's Internet web site. 222
283		-	Sec. 2. Section 17b-343 of the general statutes is repealed and the 223
284		-	following is substituted in lieu thereof (Effective July 1, 2024): 224
285		-	The Commissioner of Social Services shall establish annually the 225
286		-	maximum allowable rate to be paid by agencies for homemaker 226
287		-	services, chore person services, companion services, respite care, meals 227
288		-	on wheels, adult day care services, case management and assessment 228
289		-	services, transportation, mental health counseling and [elderly foster 229
290		-	care] adult family living. The Commissioner of Social Services shall 230
291		-	prescribe uniform forms on which agencies providing such services 231
292		-	shall report their costs for such services. Such rates shall be determined 232
293		-	on the basis of a reasonable payment for necessary services rendered. 233
294		-	The maximum allowable rates established by the Commissioner of 234
295		-	Social Services for the Connecticut home-care program for the elderly 235
296		-	established under section 17b-342, as amended by this act, shall 236
297		-	constitute the rates required under this section until revised in 237
298		-	accordance with this section. The Commissioner of Social Services shall 238
299		-	establish a fee schedule, to be effective on and after July 1, 1994, for 239
300		-	homemaker services, chore person services, companion services, respite 240
301		-	care, meals on wheels, adult day care services, case management and 241
302		-	assessment services, transportation, mental health counseling and 242
303		-	[elderly foster care] adult family living. The commissioner may annually 243
304		-	increase the fee schedule based on an increase in the cost of services. The 244
305		-	commissioner shall increase the fee schedule effective July 1, 2000, by 245
306		-	not less than five per cent, for adult day care services. The commissioner 246
307		-	shall increase the fee schedule effective July 1, 2011, by four dollars per 247
308		-	person, per day for adult day care services. The commissioner shall 248
309		-	increase the fee schedule effective July 1, 2019, for meals on wheels by 249 Substitute Bill No. 5296
	273	+	LCO No. 1858 8 of 10
	274	+
	275	+	on aging that administers the program when the department sends a 216
	276	+	redetermination of eligibility form to an individual who is a client of 217
	277	+	such agency. 218
	278	+	(l) In determining eligibility for the program described in this section, 219
	279	+	the commissioner shall not consider as income (1) Aid and Attendance 220
	280	+	pension benefits granted to a veteran, as defined in section 27-103, or the 221
	281	+	surviving spouse of such veteran, and (2) any tax refund or advance 222
	282	+	payment with respect to a refundable credit to the same extent such 223
	283	+	refund or advance payment would be disregarded under 26 USC 6409 224
	284	+	in any federal program or state or local program financed in whole or in 225
	285	+	part with federal funds. 226
	286	+	(m) Not later than January 1, 2025, the Commissioner of Social 227
	287	+	Services shall develop and implement a multilingual public awareness 228
	288	+	campaign to promote adult family living services offered under the 229
	289	+	program. Any materials developed for the public awareness campaign 230
	290	+	shall be translated into the fifteen most commonly spoken languages in 231
	291	+	the state, as determined by the commissioner. The commissioner shall 232
	292	+	(1) make paper copies of such materials available to the public at various 233
	293	+	times and at various locations throughout the state, as determined by 234
	294	+	the commissioner, and (2) post a link to such materials on the 235
	295	+	department's Internet web site. 236
	296	+	Sec. 3. Section 17b-343 of the general statutes is repealed and the 237
	297	+	following is substituted in lieu thereof (Effective July 1, 2024): 238
	298	+	The Commissioner of Social Services shall establish annually the 239
	299	+	maximum allowable rate to be paid by agencies for homemaker 240
	300	+	services, chore person services, companion services, respite care, meals 241
	301	+	on wheels, adult day care services, case management and assessment 242
	302	+	services, transportation, mental health counseling and [elderly foster 243
	303	+	care] adult family living. The Commissioner of Social Services shall 244
	304	+	prescribe uniform forms on which agencies providing such services 245
	305	+	shall report their costs for such services. Such rates shall be determined 246
	306	+	on the basis of a reasonable payment for necessary services rendered. 247 Raised Bill No. 5296
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316		-	ten per cent over the fee schedule for meals on wheels for the previous 250
317		-	fiscal year. Effective July 1, 2020, and annually thereafter, the 251
318		-	commissioner may increase the fee schedule for meals on wheels 252
319		-	providers serving participants in the Connecticut home-care program 253
320		-	for the elderly by, at a minimum, the cost-of-living adjustment as 254
321		-	measured by the consumer price index. The commissioner may increase 255
322		-	any fee payable to a meals on wheels provider upon the application of 256
323		-	such provider evidencing extraordinary costs related to delivery of 257
324		-	meals on wheels in sparsely populated rural regions of the state. 258
325		-	Nothing contained in this section shall authorize a payment by the state 259
326		-	to any agency for such services in excess of the amount charged by such 260
327		-	agency for such services to the general public. 261
328		-	Sec. 3. Subsection (b) of section 17b-370 of the general statutes is 262
329		-	repealed and the following is substituted in lieu thereof (Effective July 1, 263
330		-	2024): 264
331		-	(b) The plan developed pursuant to subsection (a) of this section shall 265
332		-	detail the structure of the demonstration project, persons served, 266
333		-	services to be provided and how they will be provided. The plan shall 267
334		-	include a timetable for implementation of the demonstration project on 268
335		-	or after July 1, 2009. The plan shall ensure that the demonstration project 269
336		-	includes, but is not limited to, the provision of the following services 270
337		-	through a Medicaid state plan amendment, a new Medicaid waiver or 271
338		-	modification of an existing home and community-based Medicaid 272
339		-	waiver: Personal care assistance services, twenty-four-hour care, 273
340		-	occupational therapy, homemaker services, companion services, meals 274
341		-	on wheels, adult day care, transportation, mental health counseling, care 275
342		-	management, [elderly foster care] adult family living, minor home 276
343		-	modifications, assistive technology and assisted living services. The 277
344		-	plan shall ensure that a person participating in the demonstration 278
345		-	project receives the level of care and services appropriate to maintain 279
346		-	such person in such person's home or community. 280 Substitute Bill No. 5296
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	311	+
	312	+	The maximum allowable rates established by the Commissioner of 248
	313	+	Social Services for the Connecticut home-care program for the elderly 249
	314	+	established under section 17b-342 shall constitute the rates required 250
	315	+	under this section until revised in accordance with this section. The 251
	316	+	Commissioner of Social Services shall establish a fee schedule, to be 252
	317	+	effective on and after July 1, 1994, for homemaker services, chore person 253
	318	+	services, companion services, respite care, meals on wheels, adult day 254
	319	+	care services, case management and assessment services, transportation, 255
	320	+	mental health counseling and [elderly foster care] adult family living. 256
	321	+	The commissioner may annually increase the fee schedule based on an 257
	322	+	increase in the cost of services. The commissioner shall increase the fee 258
	323	+	schedule effective July 1, 2000, by not less than five per cent, for adult 259
	324	+	day care services. The commissioner shall increase the fee schedule 260
	325	+	effective July 1, 2011, by four dollars per person, per day for adult day 261
	326	+	care services. The commissioner shall increase the fee schedule effective 262
	327	+	July 1, 2019, for meals on wheels by ten per cent over the fee schedule 263
	328	+	for meals on wheels for the previous fiscal year. Effective July 1, 2020, 264
	329	+	and annually thereafter, the commissioner may increase the fee 265
	330	+	schedule for meals on wheels providers serving participants in the 266
	331	+	Connecticut home-care program for the elderly by, at a minimum, the 267
	332	+	cost-of-living adjustment as measured by the consumer price index. The 268
	333	+	commissioner may increase any fee payable to a meals on wheels 269
	334	+	provider upon the application of such provider evidencing 270
	335	+	extraordinary costs related to delivery of meals on wheels in sparsely 271
	336	+	populated rural regions of the state. Nothing contained in this section 272
	337	+	shall authorize a payment by the state to any agency for such services in 273
	338	+	excess of the amount charged by such agency for such services to the 274
	339	+	general public. 275
	340	+	Sec. 4. Subsection (b) of section 17b-370 of the general statutes is 276
	341	+	repealed and the following is substituted in lieu thereof (Effective July 1, 277
	342	+	2024): 278
	343	+	(b) The plan developed pursuant to subsection (a) of this section shall 279
	344	+	detail the structure of the demonstration project, persons served, 280
	345	+	services to be provided and how they will be provided. The plan shall 281 Raised Bill No. 5296
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	351	+	include a timetable for implementation of the demonstration project on 282
	352	+	or after July 1, 2009. The plan shall ensure that the demonstration project 283
	353	+	includes, but is not limited to, the provision of the following services 284
	354	+	through a Medicaid state plan amendment, a new Medicaid waiver or 285
	355	+	modification of an existing home and community-based Medicaid 286
	356	+	waiver: Personal care assistance services, twenty-four-hour care, 287
	357	+	occupational therapy, homemaker services, companion services, meals 288
	358	+	on wheels, adult day care, transportation, mental health counseling, care 289
	359	+	management, [elderly foster care] adult family living, minor home 290
	360	+	modifications, assistive technology and assisted living services. The 291
	361	+	plan shall ensure that a person participating in the demonstration 292
	362	+	project receives the level of care and services appropriate to maintain 293
	363	+	such person in such person's home or community. 294
353	364		This act shall take effect as follows and shall amend the following
354	365		sections:
355	366
356		-	Section 1 July 1, 2024 17b-342
357		-	Sec. 2 July 1, 2024 17b-343
358		-	Sec. 3 July 1, 2024 17b-370(b)
	367	+	Section 1 from passage New section
	368	+	Sec. 2 July 1, 2024 17b-342
	369	+	Sec. 3 July 1, 2024 17b-343
	370	+	Sec. 4 July 1, 2024 17b-370(b)
359	371
360		-	AGE Joint Favorable Subst.
	372	+	Statement of Purpose:
	373	+	To require the Commissioner of Social Services to (1) study family home
	374	+	care oversight in the state, (2) compensate family caregivers, including
	375	+	spouses, who provide personal care assistance services in the
	376	+	Connecticut home-care program for the elderly, (3) collect data
	377	+	regarding adult family living services in the state and report on such
	378	+	data, and (4) develop and implement a marketing campaign to promote
	379	+	adult family living services.
	380	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	381	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	382	+	underlined.]
361	383